This means you could go home within 23 hours after surgery. (Of course, I do.) Thanks again! I am a competitive tennis player in my age division. Every hip implant has benefits and risks. Posterior hip surgery may be the best option if your surgeon makes a larger incision at the side or back of the hip joint. Also if the mini posterior approach is so effective when would it not be preferred over the regular posterior approach? Your surgeon will know better than anyone else just how stable your new hip is immediately after your surgery and how securely the surrounding tissues were repaired after the reconstruction. The pain I get is in the groin and a sharp pain in the buttocks, that feels like muscle pain. This treatment is much more definitive and predictable. In a very positive way, surgical techniques for both anterior and posterior approaches have evolved wonderfully since your surgery was done 10 years ago. The Disadvantages Of Anterior Hip Replacement Doc, Ive worked out and been physically active forever running, biking, skating, etc. I would emphasize choosing your surgeon and not the approach. I have seen 2 doctors one doing posterior, the other anterior. It does mean the surgeon has lots of room to move about though!! My problem isnt from a worn-down joint with no cartilage. It is highly recommended that you avoid bending your hips and turning your feet together as part of hip precautions. I would discuss fully your goals and concerns. I just want to thank you for the information on this site. Click to enable/disable _ga - Google Analytics Cookie. Very few metal-on-metal bearings are being placed today due to the serious potential of metallosis. What reasons would there be to use the regular over the mini? Hip replacement is a surgical procedure in which the hip joint is replaced by a prosthetic implant, that is, a hip prosthesis.Hip replacement surgery can be performed as a total replacement or a hemi (half) replacement. The surgeon I saw said that my body structure and gait does not affect which approach would be ideal for my body. The nerve which supplies sensation to the front and side of the thigh is vulnerable. That's all I know. I wish you luck on your journey. Hi, If I have a 2nd revision of my right hip is it posterior approach or the mini-posterior approach as you discuss above? In 2013 I had a THA done on the left hip. The surgeon was not at the pre-op meeting, but the PA assured me it was not that big of a deal (but to me, ALL surgery is a big deal!). I am a 49-year-old female. Its been my experience that patients who go into surgery well informed have a better experience and seem to rehabilitate more quickly. Dr. Sigmund holds a subspecialty certificate in Orthopedic Sports Medicine. In general, I would encourage you to consider all of your prosthetic joints a remarkable modern day miracle that must be cared for and respected. If an MRI demonstrates no cartilage damage or subchondral cystification (the development of degenerative cysts), a repairable labral tear and minimal dysplasia, then a hip arthroscopy may be considered. Also, how about hip restructuring instead of Total Hip Replacement. The actual length of the incision really is not important, but rather how well the components were implanted and the hip mechanics restored. Very important with both the traditional posterior and the mini-posterior approaches, if the surgeon is not able to visualize critical structure adequately, or if a problem were to arise such as a fracture, then either approach can easily be adjusted. This treatment is commonly recommended for patients suffering from osteoarthritis of the hip. People who have anterior hip replacements tend to stop using walkers, canes, and other aids 5 to 7 days sooner than people who have conventional hip surgery. The main limitation after surgery is a lack of comfort. Im now 6 weeks out and doing good. Would not make eye contact. SuperPath Hip Replacement: The Major Benefits Pain modifying drugs as well and as a course of NSAIDs might also be appropriate. There is no way that you can recover fast from having bones cut and shaped and large metal objects inserted into them. Both of these are very successful ways of doing a hip replacement. Most patients decide not to wait as long to have their contralateral hips or knees replaced after having undergone a successful surgery on the first side. Also, is it immoral for an 80 year old to have THR and cost the nations health care system $25 $35k? My second question relates to something you mentioned earlier regarding checking the published track record of the surgical team if I use an HMO, how do I find that information, and how do I know it hasnt been skewed to give more favorable results (lying with statistics)? Hi Frances, did you have surgery posterior Superpath? After reading your blog Im thankful he suggested this approach. Having a THR is a major undertaking and it is reasonable to expect the hip construct to function optimally for twenty and more years. Also there are concerns about disruption of blood supply to femoral head with this operation. I had the surgery on June 22 and I am about 5 weeks post op. You are to be commended for taking the time to answer our questions. Help. Will meet with doctor soon but when I was finally able to really exercise after surgery I overdid it and developed plantar fasciitis. Upgrade to Patient Pro Medical Professional? I think they are happier and rehab more quickly. There always are conditions or circumstances that may predispose one to limp or feel as if their legs are not the same length after surgery, but in my experience this is the exception. If not, what will my restrictions be? Getting in and out of cars, and turning over in bed. What are the risks involved? Losing weight and strengthening your muscles pre-operatively will make surgery easier and greatly facilitate your rehab. My right leg is already a bit longer than the left. This effectively moves the hip joint center, toward the bladder or midline, and improves hip mechanics. Thank you. Comparison of short-term outcomes between direct anterior approach (DAA) and SuperPATH in total hip replacement: a systematic review and network meta-analysis of randomized controlled trials. The big difference in anterior vs posterior hip replacement is primarily where the incision is made and how long it is. Thanks for giving us patients the kind of information we need to be more educated as to what questions to ask. Each surgeon approaches these issues individually. Yes, you can do very well. After reading your article on disadvantages of anterior approach and also doing extensive online search about this subject, I came to realize that anterior approach was definitely a wrong choice considering my physical build short, muscular, overweight. disadvantages of superpath hip replacement. Dear Doctor Leone, Due to security reasons we are not able to show or modify cookies from other domains. The doctor has scheduled me for total hip replacement in two weeks and he uses the Posterior approach, he didnt say anything about the mini part. Fortunately, the incidence of hips dislocating after THR is very small, especially after first-time hip replacement. Most doctors have and continue to implant hips through the posterior approach. Once it exceeds this ROM, impingement occurs. When asking a prospective surgeon about the anterior vs posterior approach he told me that it is necessary to use a smaller prosthesis which would not be as stable with the anterior approach and did not recommend it for this reason. Dr. William Leone. The bigger the ball, the bigger the ROM without impingement and the bigger the jumping distance that would be required for the hip to dislocate. One thing I do not want is any muscles or tendons cut in the procedure. Some patients who have recently had anterior hip replacement may suffer from complications such as wound healing. Its from a malformation. Minimally invasive versus standard incision anterolateral hip replacement: a comparative study. When the joint is held together by gravity and asymmetric anterior muscle tension, the tension between the ball and socket may change in various directions. The femoral nerve functions to extend the knee and also is responsible for sensations over the anterior and medial aspects of the thigh, medial shin, and arch of the foot. Most patients after a bilateral procedure would not go home but rather a rehab unit. One of the potential disadvantages is that because the surgery is performed through the front of the hip, there is a risk of damaging the hip joint and the surrounding muscles and tendons. Surgery carries increased risks because of these conditions, but by defining the risks and optimizing any underlying conditions, the risks can be minimized and hopefully managed. Hip Replacement Surgery: How it Works, Recovery Time | HSS Please comment. Will I still be able to do all of these things? Many of these stems have very little if any long term follow-up, although some appear to be doing well in the short term. Despite the fact that this usually takes two weeks or longer, patients can return to work when they feel completely comfortable. But Im impressed with your blog and responses, so am writing to ask you about an apparently new procedure in which the surgeon uses a customised implant, utilising pre-operative 3D CT scanning. There are a few complications that can occur with anterior hip replacement surgery. I encourage you to do the same. I am a 53 year old active, distance runner. Traditional hip replacement surgery is no longer an option, but it is less painful and has a number of advantages. Comparison of short-term outcomes between direct anterior approach (DAA SuperPath Hip Replacement (Surgery) : 3D Animation - YouTube DAA and SuperPATH were equal in functional outcome and acetabular cup positioning. Surgical Approaches in Total Hip Replacement It is much better to precisely release and cut rather than tear or fracture. Stay was 2.5 days. I have the hospital but am deciding on the surgeon and which approach is best. Ken. Both problems are on the right side of my body. The anterior hip can be easily and naturally recovered by walking, simple home exercises, and isometric exercises. I have a yr or more off work so I have the time to heal properly but scared to sit or move an Inch as I dont want to dislocate my hip again I dislocated my left hip in a resturant while eating lunch with my 10 yr old we both suffer from ptsd now and stayed in the emergency room for 30 hrs before they rushed me to the city hospital. Hip Resurfacing vs Total Hip Replacement - sosbones.com I think there may be increased associated complications. I had no inkling of this till he showed me on the x-ray. Glazener C, Fraser C, Hutchison J, Vale L. Single mini-incision total hip replacement for the management of arthritic disease of the hip: a systematic review and meta-analysis of randomized controlled trials. Have you heard of something like this, and if so, is it worth it? Talked to my foot doc and we decided on the Topaz procedure which has good results. I assume its something near my groin. Hospitsl staff 4 mts later am using Historically, higher dislocation rates were reported with the posterior approach, but it still was used for its many other advantages. Why would the doctor not have that at their finger tips? Recently the doctor doing anterior decided because of thin bone, he should do direct lateral approach. Thank you for this! I feel good now and walking good now but feel so disabled as I dont know if my hip will dislocate again.I am sorry if you may have responded to some of these questions already as it is so much information to absorb and I dont want to make a wrong decision again. Doc says once recovered I should avoid flexion with adduction and internal rotation. What is most important is choosing your surgeon. Ill be 60 at the time and Im 54 and weight about 130 lbs in fairly good shape. What Ive been able to achieve is find two nerve supplements that have taken away the burn/tingle on my thigh. It sounds as if you had a wonderful surgeon. Most individuals who have had total hip replacement surgery fall into this category and simply resume their lives.. An anterior capsule is the only soft tissue cut during this procedure to insert the implants. There are several positions to avoid after anterior hip replacement, as they can put unnecessary stress on the new hip joint and lead to dislocation. Similarly, an engaged medical team needs to be available to help with care after surgery. Hip implants are medical devices intended to restore mobility and relieve pain usually associated with arthritis and other hip diseases or injuries. Above the ankle to the thigh.Had to use leg brace to I typically do hip replacement on the get anterior approach in 90% of my patients. Dear Dr. Leone, Also I have read that there is a sharp learning curve that must take place in order to do the direct anterior approach. William Leone. It is generally agreed that the temporary numbness is more than balanced out by the substantially improved recovery, reduced pain, absence of a limp, faster return to function, and virtual elimination of the risk of hip dislocation. No i just had the posterior method which has a larger incision. I plan to retire from working full time June 2017 and am concerned about having appropriate insurance after that. I think tennis, dancing and horseback riding are fine. I am an obese female and will be 62 in February. What determines the differences? As a result of the interventions, the surgeon has a better view of the hip joint. Thank you, Lisa. I wish you the best of luck with your care. Some people may find that traditional hip replacement surgery is the best option for them, while others may prefer a minimally invasive procedure. I had a consult with a surgeon who does posterior and cuts muscle & tendons. what is the super path method I've never heard of that before, superpath is just the fancy name for a smaller incision , less trauma and quicker recovery or so they say from what I have read along with more surety of the length of leg . Potential Disadvantages of Anterior Hip Replacement Anterior hip replacement does have a few limitations: There may be wound healing issues Research suggests that people who undergo anterior hip replacement may be more likely to have a problem with wound healing, particularly infection. posterior surgery . Not putting you on the spot, but would it be advantageous for me to drive 200 miles to have a consultation done by you? disadvantages of superpath hip replacement About this injury to me. I had an anterior approach hip replacement. We can do this because of improved plastics. In 2014 I had to do another THA, this time on my right side. Very strange I am wondering if having mild hip dysplasia is a factor in which approach is used. When people loose independence and mobility, not only does the quality of life suffer, they are much more likely to develop a myriad of medical problems requiring even more-expensive and/or long-term care, including loss of independent living. Overall, it sounds as if youve had an excellent result and wonderful recovery following your hip replacement. I wish you only the best. daniel neeleman net worth . It's what compelled me to seek out different methods and post here.. You will find the surgeons will all give the pros but never the cons what ever the method. I am allergic to narcotics . How would a hip replacement be done? What is the best stem and ball/socket combo to use for someone that ones to play tennis? Many manufacturers are responding to the surgeons desire for shorter stems and many are now available on the market. I had the mini-posterior at MGH hospital. Each is safe, effective, and capable of delivering exceptional results. It is critical that the patient is aware of the risks, benefits, and alternatives of the procedure. The art of surgery should mimic a well rehearsed ballet or symphony. [QxMD MEDLINE Link]. No special surgical equipment is required when performing a mini posterior. Understand that every total hip, no matter which approach is used to implant it, has the potential to dislocate. Lateral femoral cutaneous nerve injury is the most common injury incurred during an anterior approach. as being in breach of those terms. If its a struggle, then the situation needs to be reassessed. It is so important to stay focused on the outcome of your hip replacement surgery: excellent results both short- and long-term with minimal risk of injury or complication, and not lose sight of the real goal, which is to create a perfectly positioned reconstructed hip that is stable, balanced and has the best possible chance of lasting more than twenty years. A hip replacement with an anterior component does not require major muscle cuts and thus patients are less likely to experience pain and require less medication. Finally, hip replacement surgery is expensive and may not be covered by insurance. According to the meta-analysis, DAA (depressing the anterior hip joint by using a metal rod) is associated with significantly shorter hospitalizations than lateral approaches, as well as increased functional rehabilitation and lower perceived pain during the first few days after surgery. We can help you make the best decision for your knee replacement, and our friendly staff is available to answer any questions you may have. There arent any activities that you can do with a resurfaced hip that you cant do with a total hip. Studying a hospital and physicians track record before you commit is important. Can You Use An Inversion Table With A Hip Replacement This technique is also referred to as the . It is critical to consider the pros and cons of each option before making a decision.