As a result of this precaution, it is difficult to sit on low chairs, sofas, or toilets. My right leg is already a bit longer than the left. Also there are concerns about disruption of blood supply to femoral head with this operation. I am a sixty five year old active male and need THR on my right hip. Is AL better than P for this? The surgical technique for a SUPERPATH Hip Replacement was developed as an advancement to traditional total hip replacement. I take care of many individuals who have a total knee and hip replacements on the same side. Now 1 yr later dont have buckling/giving out but a lot of pain is there and after walking around, after about 20 minutes it hurts to lift leg forward, also good hip starting to hurt. The anterior approach is not as muscle sparing as some would argue. SuperPath approach is the least invasive due in part to the minimal amount of tissue damage. I will need the other hip done within the next 6 months, and despite all the talk of the anterior approach- I can use myself as the best judge to the best method. Would not make eye contact. Will I still be able to do the things I like to do? Diagnosed possible labral tear. Hip replacement surgery can open up a world of possibilities for people who have lived with pain and restricted movement. An anterior approach to hip replacement allows the surgeon to perform more limited views of the hip joint during the surgery, making the procedure technically challenging for less experienced surgeons. In my practice, I cement an Exeter stem in a significant percentage of my patients who undergo THR . Part of those possibilities includes a better and more comfortable sex life. In my experience, after four to six months most patients simply return to normal activity. Because the dissection is over the front of the hip, a number of patients will experience residual pain and tightness anteriorly (in the front of the hip) at least early on. An anterior hip replacement is not covered by a specific credential system for orthopedic surgeons. Many studies suggest that any limp or clinical weakness resolves after approximately three months. The anterior approach typically does not violate this structure. In addition, patients prefer the anterior approach due to the absence of pressure on the Femoral nerve in the anterior approach. If not, what will my restrictions be? I went in with high expectations of coming out so much better off and here I am 5 yrs out limping more than ever and a NUMB thigh and worse knee and weak ankle. I am Australian so no business from me but it has helped me become happier with my prospective surgeons judgement that he will offer me a posterior THR (hopefully the minimally invasive) when my insurance allows the procedure to occur. 3 years ago, I have been less active this past year and am concerned that losing weight prior to surgery might be an issue, Am also wondering about my auto immune issues and the implant. He is one of the few surgeons in the U.S. that performs total hip replacement via a superior capsular approach, the most soft tissue-sparing hip replacement available and is an industry educator in the . Studying a hospital and physicians track record before you commit is important. Being discharged to a rehab unit is now the exception. I have insurance with very high deductible and I am scared of the debts I might incur afterwards too ( where I am planning to do it I might not have to pay any money). Some in the early period have good track records, others do not. Ceramic-on-polyethylene is currently the most popular hip replacement material, representing 50.6% of all hip replacement cases back in 2014. No feeling in my leg and no movement Do you agree? Any feedback will be appreciated. Doc says once recovered I should avoid flexion with adduction and internal rotation. All: Also, when a single joint is replaced versus bilateral, there is significantly less bleeding and hence a much decreased need for transfusion. No Muscles Cut is for billboards. They are encouraged to be very active and most stop using a cane, can drive their cars and are exercising in the pool, just two weeks after surgery. Because of the restricted view provided by the anterior incision, the anterior incision is a technically demanding procedure. Thanks. We may request cookies to be set on your device. I would research and find the physician and hospital that will give you the best chance of doing well. Along these same lines, there is a smaller incidence of sciatic nerve injury with the anterior approach but an increased incidence of femoral nerve injury. I think tennis, dancing and horseback riding are fine. I really dont know where to go from here. I had an anterior approach hip replacement. This is actually a good sign. The pain is really inconsistent, one min I will be walking fine and the next it catches and is very painful, then it may go away or may not. I am going to get evals from 3 docs. Finding the right surgeon is critical, because your care is about so much more than just fixing your hip. Anterior hip replacement has the potential to cause complications and pose some risks. I was told to wait 6 weeks before I resumed my exercise regiment. There is no definitive answer to this question as different people will have different opinions and preferences. It is also possible to have an anterior hip replacement during pregnancy. I think researching the hospital where you will have your surgery is very important. If so, how long until I can get back to normal living? Thank you so much for taking the time to inform us! Im now 6 weeks out and doing good. My husband has a plastic valve (done in 86) and synthetic assending aorta and triple bypass (done in 2013)very successful surgery. If these values are elevated, further investigation with hip aspiration should be considered. I think it was sensible being careful on the other hand and I was told not to cross my legs. The mini-posterior approach involves separating the muscle fibers of the large buttock muscle located at the side and the back of the hip. 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. Choose your surgeon. Use of the forums is subject to our Terms of Use Dr. William Leone. If you would like a personal consultation, please contact our office at 954-489-4584 or by email at LeoneCenter@Holy-cross.com. Infection. I furniture surfed in the house and used a stick outside.I was hopeless with crutches, but I think it is recommended we should use them, particularly to ensure we don't get a limp and build our leg up properly. With a bilateral procedure during a single anesthetic, the blood loss would be double and there would be a much higher likelihood that my patient would need transfusion post-operatively. I assume PTHR is referring to partial hip replacement. Should I look to another approach and surgeon? Yes, Im angry. I am a 49-year-old female. In 2014 I had to do another THA, this time on my right side. The anterior hip can be easily and naturally recovered by walking, simple home exercises, and isometric exercises. Others will be empowered when they read and relate to you and/or your experience. J Orthop Surg Res. Surgical approach is important but its just one of many important variables. Typically, the new cup will be medialized to gain coverage and correct the abnormality that lead to your arthritis. I sit on a cushion in the car to lift me up. Our clinical information meets the standards set by the NHS in their Standard for Creating Health Content guidance. 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. Posterior, mini posterior or anterior? General comments will be answered in as timely a manner as possible, Hip & Knee Surgery Surgical Techniques If it is from intra-articular hip pathology such as osteoarthritis, which is very common especially in your age group, then most likely stem cell injections will not be affective and you would benefit from a total hip replacement. 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. Will I still be able to do all of these things? I dont want a long recovery time as I am very active. Remember, what youre hoping to do is have a hip construct that will last 20 years or more. Traditional hip replacement surgery is no longer an option, but it is less painful and has a number of advantages. Maybe someday our nations health care system will measure up to that of France, Norway, Switzerland and others, in which their governments are investing half of the GDP that we are wasting. 2023 Brandon Orthopedics | All Right Reserved, hip replacement pain reduction surgery patients, The Best Sneakers For Hip Replacement Patients, Anterior Hip Replacement Surgery: The Pros And Cons, The Truth About Spinal Stenosis: Causes Symptoms And Treatments, Can Years Of Surfing Contribute To Spinal Stenosis, The Effects Of Spinal Stenosis And Carpal Tunnel, Should I Apply Ice Or Heat To A Compression Fracture, How Does A Soft Bed Prevent Healing Of Herniated Disc, Herniated Discs: How To Sleep Without Worrying About Rupturing Your Discs, If You Have A Herniated Disc You Know The Excruciating Pain It Can Cause. Conclusions SuperPATH approach showed better results in decreasing incision length and early pain intensity as well as improvement of short-term functional outcome. Currently, I seldom do bilateral THRs under a single anesthesia but instead stage the surgeries 2 1/2 to 4 weeks apart, depending on my particular patient and his or her needs and desires. In 2013 I had a THA done on the left hip. Typically, most are eager to go home the very next day; many have already progressed to a cane, which they will not use very long. In general, people who are older, heavier, or more active may not be good candidates for this type of surgery. Low-risk anterior approach patients are those who have significant deformities in their proximal femur as a result of previous trauma or dysplasia, or who have previously suffered from acetabular bone fractures. Recently the doctor doing anterior decided because of thin bone, he should do direct lateral approach. It's cut off and removed through the hole. Also, if a surgeon knows in advance that a certain range of motion is desired, can they provide some adjustment in surgery to help accommodate that desired movement? After reading a few articles on anterior vs posterior including yours, I know now that his decision to use the posterior approach is the best one for me! Infection. Consult an orthopedic surgeon who specializes in hip replacement surgery if you have a hip problem. Stay was 2.5 days. 3. Fortunately, you have already experienced a THR and have done well. Patients who have this surgery no longer require walkers, canes, or other aids 5 to 7 days after the operation, in comparison to those who have hip surgery. Its been 8 months now. I should think that all your expectations are appropriate for the activities you look forward to, especially considering youve already done so well after your knee replacement. We need 2 cookies to store this setting. Some surgeons will use 2 incisions, both the anterior and superior approach. That being said, if the foot is now a much bigger problem than the hip, you may have to deal with that first. There are a few disadvantages to hip replacement surgery. Thank you, Lisa Blumthal. Just need reassuranceI am stressing he is fine. There has been an increase in the range of motion. This is used when the cartilage in the hip is severely damaged by osteoarthritis or other conditions. Specific protocols, therapy and what positions you will be asked to avoid after surgery and for how long will be directed by your surgeon. Thank-you. In the United States, a traditional posterior approach is the most commonly used. This site uses cookies. Granted I do deal with lower back OA and right knee OA and now all worse and now foot/ankle mess, all on right hip side. It is critical that the patient is aware of the risks, benefits, and alternatives of the procedure. Adult patients who have a deteriorated hip may be candidates for total hip replacement. I wish your patient well. I love that you take time off to reply to these messages it is commendable. I suspect there is significant underlying osteoarthritis related to your labral pathology. Tina, which procedure did you have? There are a few disadvantages to hip replacement surgery. SuperPath hip replacement is a newer method and has been used since 2019 at Leicester's Hospitals. A major muscle is not cut during anterior hip replacement surgery, so pain is reduced and major muscles are not cut after the operation. Most traditional hip replacement models are metal-on-plastic varieties. I dont know what happens on that tablewas he in a hurry on Friday afternoon. Not putting you on the spot, but would it be advantageous for me to drive 200 miles to have a consultation done by you? Original Medicare (Part A and Part B) will typically cover hip replacement surgery if it's medically necessary. Note that blocking some types of cookies may impact your experience on our websites and the services we are able to offer. . DAA and SuperPATH were equal in functional outcome and acetabular cup positioning. Ultimately, you and your husband need to choose the surgeon who you both feel will provide the possible best care, based on reputation and your personal comfort level. SuperPATH showed better results in decreasing operation time, incision length, intraoperative blood loss, and early pain intensity. I had to cut some strength exercises out leg lifts, hip sled. The first surgeon never mentioned this condition at all. You can also change some of your preferences. I have the hospital but am deciding on the surgeon and which approach is best. Also, because technically it is easier, many patients are being reconstructed with very short stems which are press fit into the bone during an anterior approach. It is highly recommended that you avoid bending your hips and turning your feet together as part of hip precautions. The anterior approach, as opposed to the lateral or posterior approach, uses a small incision in the front of the hip. It would be interesting to hear what you have to say Doug. I don't think there's a one size fits all when it comes to hip surgery. I have been doing ALOT of research about the different approaches to THR and looking for the absolute best surgeon. Many in business or who own their own businesses will stay home for only one week and then return to their work place because they are bored and would rather be productive and busy. Or are x-rays definitive for determining the exact reason for THR? 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. My hope is that some of these symptoms will improve with time. Finally, hip replacement surgery is expensive and may not be covered by insurance. Not wanting to go through all the restrictions, I was considering anterior for my right hip, which would require not having it done locally since doctors here have been doing it for only 1 year. Due to security reasons we are not able to show or modify cookies from other domains. We have an appointment today to discuss the plan of action. Ive done PT and plan to continue working on strengthening my core and flexibility of those large muscles. A miniposterior approach uses the same intervals as the standard posterior approach but simply less tissue is released for the exposure. 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. Dr. William Leone. Each approach has advantages and disadvantages. Glad that after lots of PT and massage and medial branch block for back issues with NO!!! Finally, I would choose a doctor with whom you connect and whose staff is engaged and knowledgeable.

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