How does it affect the actual success of the I am a 67 year old woman who has danced semi-professionally and has always been very active including doing Ashtanga yoga and caopeira. Should I go for this or should I opt for the mini posterior. Yes, Im angry. The actual length of the incision really is not important, but rather how well the components were implanted and the hip mechanics restored. External rotation of your feet should be limited (avoiding them twisting to the outside as Charlie Chaplin does) and hip hyperextension should be avoided. Last summer I wiped out on my bike and snapped off the top of my right femur, with a diagonal break. In the case of a worn or damaged ball and socket, artificial parts can be used to restore joint function. There is less risk of neurological injury. My surgeon has told me I will need PT 3 times a week for 6-12 weeks is this too long? Get Directions, Phone: 954-489-4575 Further, rehab after hip arthroscopy often requires partial weight bearing on the operative side and that would be difficult with newly operated THR on contralateral side. I cant find anything that addresses replacing a hip that is dysplastic. I would emphasize choosing your surgeon and not the approach. This procedure differs from traditional hip replacements in the following ways: There is no surgical dislocation of the hip. If these values are elevated, further investigation with hip aspiration should be considered. 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. What, if anything, can be done to revive femoral nerve and get my thigh muscles back in normal? I, too, am struggling which approach to have. Hip replacement - Mayo Clinic The size of the incision is determined by how large and tight the hip/thigh is and how much tissue (fat and muscle) exists between the bones of the hip and the overlying skin. The source of your hip pain must be diagnosed. Also, be aware that as the nerve recovers, the smallest C fibers within the nerve recover first, which can cause a burning discomfort. Extensive release of the posterior capsule including . If so, how long until I can get back to normal living? I wish you a full and uneventful recovery. Mine certainly have. I worry that replacing it with a differently configured socket could make things worse rather than helping. I am unsure whether the minimal invasive posterior is available in SA. Either and all body types lend themselves to the posterior approach because it is more extensile (can make it bigger and release more soft tissue structure if needed). 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). The surgeon makes 2 incisions one bigger than the other on the rear side and separates the muscle and tendon to get to the hip instead of cutting the muscle and tendons to get to the hip. Prior to surgery, you need to be evaluated by your primary care doctor and any other specialist who helps manage your care, so the conditions you have can be optimized. They thought surgery to repair it would give me about 5 yrs. It seems reasonable and I trust my surgeon but would like to know what I'm in for post op and beyond. This is particularly true if the person is overweight, has very muscular thighs or is short. Hip pain, soreness, and stiffness can quickly become unbearable and sideline us from the things we enjoy the most. There are many different quality implants (just like surgeons and hospitals). What is the best hip replacement option: anterior or Posterior? disadvantages of superpath hip replacement I am concerned that I may have a pinched nerve and that that is what is causing all this pai as the pain is severe only in certain positions but when I am tired I also have a throbbing pain in the sciatic region.talk about the golden yearsI thank you from the bottom of my heart for the kindness and caring that you do in answering all these questions. Risks of Hip Replacement Surgery The major risks include the following: Blood clot: We do reduce risk of this by using blood thinners (Enoxaparin, Aspirin or Coumadin), TED hose (compressive stockings) and compression boots on your feet to increase circulation. 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. Thanks again for this great blog! Clearly, he or she has earned your respect and confidence. Why would the doctor not have that at their finger tips? I didnt spend time on boards talking for eons about peoples outcomes.probably a good thing I didnt. Thank you, Rita. THOUGHTS? Like you said, consistent outcome is important and this surgeon is excellent and I have great faith in him (Im a physical therapist and see his patients post-op so get to see the, at least short term, results myself). Dr. Robert Sigmund is a board-certified orthopedic surgeon and a sports medicine physician based in St. Louis, Missouri. Just because hardware in your foot needed to be removed after repairing what sounds like a calcaneal (heel) fracture, absolutely does not mean that your body rejected the metal / hardware or that your body will reject the prosthesis your surgeon will implant to reconstruct your hip. I find it curious that you report having a good result for the first five months after your surgery as this suggests that the surgery was done for the right indication, i.e., you did well and were pleased for the first five months after THR. I have written to you to learn what are the surgical considerations for someone with shallow hip sockets like mine. Types of Hip Replacement (Approach) Hip replacements can be preformed through a direct anterior approach, an anterior lateral approach, a lateral approach, a posterior approach, and a superior approach. Also many folks develop peripheral neuropathy in their lower legs, which also becomes more common with age. I would rather my patient get half as much anesthesia. SuperPath hip approach. What Ive seen in my practice is that the more total hips I do, the less restrictions I place on my patients and the more active my patients are. 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. The doctor is planning a traditional posterior. Above the ankle to the thigh.Had to use leg brace to Im 51, 59 and 148 and want to get back to tennis etc, this has been long frustrating process. He treats a variety of hip, knee, and shoulder conditions, and performs hip and knee total joint replacements. I prefer reconstructing the most symptomatic side first. I have been told that I can fly 48 hours after surgery?? SuperPath approach is the least invasive due in part to the minimal amount of tissue damage. These other conditions need to be defined and hopefully ruled out as the primary source of pain. I am looking at how many hips they have done and where they are doing them. I am scheduled for bilateral hip replacement at the end of August. My advice is to consult with your surgeon regarding how stable the replaced hip is and the most appropriate rehab to follow post-operatively. This approach has a number of potential advantages, including a shorter hospital stay, less pain, and a quicker recovery. If I do a single hip or knee replacement, that patient is out of bed standing and, in most cases, walking the afternoon of surgery. Would appreciate any input you might have on the auto immune issue, and weight etc. Really Great. Thank you. 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. I was initially sent to a surgeon to consider repair but he said my chances of being happy with the outcome were only 30% and suggest a THR. Personally I had the posterior approach and cannot see how I could have recovered any faster . Infection: You are given IV antibiotics before and after surgery. Rather, they say Bill, please just do what you have to do and do a great job. Some of the most common considerations are age, weight, activity level, and the presence of other health conditions. Hip replacement surgery & recovery time | TRIA Orthopedics - HealthPartners Your article is the first Ive read in which no muscle or tendons are cut in any approach other than the direct anterior approach. Because I have scfe also in my left hip, I will have to have it fixed too. If I think you may be a candidate, I will refer you to a doctor in our area that does. Lastly, if one has had P or AL is there anything that can be done to offset the need for restricitons? The chances of developing a revision surgery after a posterior hip replacement are low, but you should keep all follow-up appointments with your surgeon and inquire when you can resume activities that go beyond 90 degrees or bend down to pick up something small after your procedure. And does A really have none. I think the recovery time is the same though. Adults of any age can be considered for a hip replacement, although most are done on people between the ages of 60 and 80. I have read your articles about procedures (anterior vs posterior). There are a few disadvantages of anterior hip replacement that patients should be aware of before undergoing the surgery. My clinical impression is that more patients experience some degree of residual groin discomfort or tightness after the anterior approach as compared to the posterior approach, but that it tends to resolve with time. He is well known as a top doc for 20 yrs & I was persuaded because the mini posterior has less chance of nerve damage & the surgeon has more options for types of spikes, which your article explains well. Stay was 2.5 days. This suggests that something changed after five months. Regardless, the overall incidence of dislocation for every approach is smaller due to use of larger femoral heads and enhanced closure techniques. When done well, your body does well with this technology. Currently we use standard ways, called either posterior or direct lateral approach. We provide the best cash prices and customer care in the industry. Thank you for sharing with others the nerve supplements that youre finding affective. I had a posterior, the surgeon did not cut any muscle, they just move them now. The surgeon I saw said that my body structure and gait does not affect which approach would be ideal for my body. Click to enable/disable _gid - Google Analytics Cookie. Personally, I would not gamble with my health. bible teaching churches near me. The information I have gathered seems to indicate the anterior approach is more inherently stable, making precautions unnecessary. The most common reason or diagnosis that leads me to replace the hips of young women is hip dysplasia. 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. A ceramic-on-ceramic bearing is also a very good bearing. I was really careful bending etc for four weeks until I saw the physio, who said "oh you could have touched your toes if you had wanted to!" Over time, untreated hip dysplasia or hip impingement can lead to arthritis and, eventually, hip replacement surgery. It was discovered that I had a torn Labrum. Please do not take this as an attack, but your article seems biased on your experience (great results with min. It allows the surgeon to work between the muscles and tendons without removing them from their anchoring points on the hip or thighbone. Click on the different category headings to find out more. I also regularly receive Rolfing treatments which has helped me manage pain and maintain what mobility I have. Individual results and activity levels after surgery vary and depend on many factors including age, weight and prior activity level. This is used when the cartilage in the hip is severely damaged by osteoarthritis or other conditions. Im not sure why you developed a problem with your IT band. Not putting you on the spot, but would it be advantageous for me to drive 200 miles to have a consultation done by you? A couple of things I am hoping you will explain using laymans termology. After the direct anterior approach, there is generally no hip precautions required, and motion is not restricted. Since a significant amount labrum has been removed, I think another attempt at arthroscopy would prove very disappointing and I would not recommend it. Do either of your techniques require the traditional anterior or posterior precautions? Dr. Sigmund holds a subspecialty certificate in Orthopedic Sports Medicine. Should one of these events occur during a mini-posterior procedure, they are easier to recognize and correct. The anterior approach typically does not violate this structure. We use cookies to let us know when you visit our websites, how you interact with us, to enrich your user experience, and to customize your relationship with our website. Why is that? 3. To have your other hip replaced through a different approach is a decision you need to make with your surgeon. Download scientific diagram | (a) Components of a total hip replacement; (b) The components merged into an implant; (c) The implant as it fits into the hip [15]. The last page is asking the participant to self score their health that day out of 100. I would recommend having an honest discussion with the surgeons you are considering. The first is that it is a major surgery, so there is a risk of complications such as infection. Many modern-day femoral stems are considerably smaller or more bone sparing than well-functioning stems of the past. Posted If possible and a pool available, I encourage my patients to walk and exercise in a pool and / or swim, starting at two weeks when their suture is removed. Ken. If you do not want that we track your visit to our site you can disable tracking in your browser here: We also use different external services like Google Webfonts, Google Maps, and external Video providers. He is the founder and main author of brandonorthopedics.com, a website that offers valuable resources, tips, and advice for patients looking to learn more about orthopedic treatments and physiotherapy. Dear Dr. Leone: Since then, SuperPATH has enjoyed excellent success. 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. Dear Mary, With the ease of movements during pregnancy, you will be able to move around more freely. I live in Staten Island and need rt hip replacement. Usually a hip problem is addressed before a knee or foot problem because by solving the hip problem first, the knee or foot often improves if the pain is referred from the hip (more common with knee pain) or if by addressing the hip, the body mechanics and the fluidity of gait improve. Walker to get around. By adhering to the surgeons instructions as well as their pre- and post-operative instructions, you can reduce your chances of complications. My acyive 60 year old husband is scheduled to have Mini posterior total hip replacement in 6 weeks. Does it really not matter which approach I have, posterior or anterior? Many others feel the same. Additionally, people with certain health conditions such as diabetes or heart disease may also not be good candidates. This effectively moves the hip joint center, toward the bladder or midline, and improves hip mechanics. Appalachian orthopedic surgeons perform revision surgery as well as mini-posterior and anterior approaches. When discussing the options, my surgeon all of a sudden suggested performing anterior approach. Of note, I am a RN with 30 years of experience and took this decision very seriously. Its been six months since surgery, my operating doctor keeps feeding me with lets wait another month stuff. About my surgery: I had to wait 30 hours before surgery, two days later I was released, within two more days I stopped using my walker. I do not want the approach to dictate the optimal construct which I hope will last 20 years and more. Can you explain it to me as he didnt go into detail. Problem is that we have seen two doctors and both seem great but are on two extreme sides of the fence. There is a possibility that blood loss may be reduced as there is less unnecessary exposed bone surface left to bleed. If, on the other hand, the leg length difference is creating hardship and possibly discomfort in other joints such as the lower back, knee or ankle, I would consider proceeding with contralateral THR sooner rather than later. Does the mini posterior hip replacement conserve more femur and allow for future surgeries if needed ? crackling noise/pain, cannot bend them or kneel in church or get on the floor to do exercises, I am very afraid to ending up in a wheelchair or having to use a walker the rest of my life.I am a very active 65 year old, and very, very worried about the hip surgery. What reasons would there be to use the regular over the mini? Most doctors have and continue to implant hips through the posterior approach. Publications 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!). There are hybrids of the surgey from what I can see. I still maintain that by far the most important decision patients must make is choosing the surgeon who will do their surgery and take care of them, then trusting that individual to choose the approach, prosthesis and make a million other decisions that deliver as perfect a result as possible. When the stem is placed in the femur, it still destroys the same amount of bone for implantation, regardless of which approach is used. As long as you do the necessary surgeries, you will eventually break your femur, but only if you do enough. Being cared for in a hospital that specializes in joint replacement and has an extensive specialty medical staff also is key. 3 years ago, If your surgeon did a great job, that is something to respect. Following the anterior approach, we provide you with a number of precautions and positions that you should avoid if you are in danger of being discomfited. I also would find out your surgeons recommendation regarding activities and restrictions. Patients who are significantly overweight (I specifically assess the amount of tissue between the skin overlying the lateral hip and the greater trochanter), who have significant long-standing contractures and restricted ROM, congenital dislocation, and marked acetabular protrusion (when the femoral head wears centrally into the acetabulum) typically require a larger incision and more soft tissue releases. I read about this type of mini hip replacement being done in the UK and just wondering if mini hip replacement means the same thing in the US . There is also a small risk of infection at the surgical site. SuperPath Hip Replacement (Surgery) : 3D Animation - YouTube Many, many interactions and decisions go into the final result as well as someones perception of his or her result and experience. Pain Management I think they are happier and rehab more quickly. Ive since met 3 others who ended up with the mess that Im dealing with also. As of 2020 only Dr. Leone is using the latest hip technique called the SPAIREtechnique where patients no longer have hip precautions after surgery. I think researching the hospital where you will have your surgery is very important. What Is Superpath Hip Replacement - HipsAdvice.com as being in breach of those terms. It is difficult to get that from information which I find curious. In my last blog post, I discussed minimally invasive surgery with regard to hip replacement. The idea is it should be a little less painful if the muscle, tendons and nerves are not disturbed. In my 25 years of practice, the variable that seems to have changed the most is how quickly people recover from this surgery when done well. I am suffering from a severe range of motion where I cant put my left sock on or tie my left shoe, I can barely get in and out of low cars and sitting up at a table hurts too! I suggest you discuss your concerns with your surgeon. Do you also do arthroscope surgery? Many times, the depth of the destruction that is found during surgery is much more advanced than initially anticipated, particularly as we age.