I wish you a full and satisfactory recovery. I suspect that your surgeon has continued to refine his or her technique based on experience over the past five years, in the same way I have. There are various ways of doing a hip replacement. Doctors use metal, ceramic, or plastic replacement parts. These can include damage to blood vessels or nerves, dislocation of the hip, and infection. If your surgeon did a great job, that is something to respect. I spoke to the surgeon, he believes it may take up to 6 months to get better from this neuropraxia. I think the recovery time is the same though. 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. We are an online blog dedicated to providing comprehensive and accurate information about orthopedics and injury prevention. Some patients who have recently had anterior hip replacement may suffer from complications such as wound healing. The impingement can lead to a levering out of the ball from the socket. This interval must be developed and the muscles must be separated in order to reconstruct the hip. No specifics were given to me from the orthopedist . Not sure exactly what that means. Click to enable/disable _gat_* - Google Analytics Cookie. 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. I also regularly receive Rolfing treatments which has helped me manage pain and maintain what mobility I have. Thru X-rays Ive been told both hips are bone on bone! Ill know a lot more after we meet and I review your X-rays. In a very positive way, surgical techniques for both anterior and posterior approaches have evolved wonderfully since your surgery was done 10 years ago. If they did develop five months post-op, then you have to consider that it could be a manifestation of back pathology compromising a nerve root. The questions youre asking are 100 percent appropriate. Hi guys im 43 and live in Australia and due to have hip replacement in 7 weeks but im so confused as my surgeon is doing the posterior and im off work for 6 weeks where i here people having the anterior and going back sooner and no restrictions on hospital discharge any advice. Its been my experience that patients who go into surgery well informed have a better experience and seem to rehabilitate more quickly. It was discovered that I had a torn Labrum. When the capsule is fully healed, it forms strong ligaments that will eventually regrow (it will take about 4 months for the capsule to form again). Hip replacement is a fantastic operation that can help relieve pain, improve daily function, and improve quality of life. Its interesting that when we critically analyze all the variables that ultimately make up the experience that one person has compared with another, or that one person experiences on one side versus the other, we come to recognize its not so straightforward. SuperPath hip approach. This is described as a posterior approach because the actual hip . Also on MRI there was a cyst (good size). Can you please on the various points in the post and perhaps also elaborate on the last point. Should I look to another approach and surgeon? Egton Medical Information Systems Limited. Most of the restrictions are removed at that time, although I still advise common sense, particularly for the first three or four months. It is critical to make the right decision regarding anterior hip replacement surgery in each case. After the direct anterior approach, there is generally no hip precautions required, and motion is not restricted. Would appreciate any input you might have on the auto immune issue, and weight etc. I have linked back to several blog posts below that will give you more in-depth information. My husband tells me that I cry out in pai as I turn over during the night. Infection. I definitely would not recommend a hip scope and THR during one anesthetic setting. It is 100 percent normal and expected to be scared before surgery. The most important variable is how quickly the person is motivated to return to work. I had an anterior approach hip replacement. You can check these in your browser security settings. The SUPERPATH hip replacement is a new technique using superior capsulotomy that allows for implantation of the total hip components under direct vision through a single incision. What is most important is choosing your surgeon. Other preoperative guidelines, such as using a prescribed pain medication and keeping the incision clean and dry, should also be followed by patients. Which approach did the doctor take? If your surgeon has recommended surgery, I assume youre no longer getting adequate relief of pain or able to remain active with conservative measures. Because of the straightforward exposure of the femur, there is less risk of femoral fracture or poor implant positioning. Once it exceeds this ROM, impingement occurs. There is a chance of nerve injury with any type of hip replacement. Each is safe, effective, and capable of delivering exceptional results. This often leads to a less than optimal component position. Email us. This effectively moves the hip joint center, toward the bladder or midline, and improves hip mechanics. I have written to you to learn what are the surgical considerations for someone with shallow hip sockets like mine. I also would encourage pool walking or swimming. This is used when the cartilage in the hip is severely damaged by osteoarthritis or other conditions. I ask my patients to restrict certain positions that exceed the mechanical limits of the artificial hip for the first six weeks. Upgrade to Patient Pro Medical Professional? Hip dysplasia is a very common underlying cause of hip osteoarthritis. Hip replacement - Wikipedia Original Medicare (Part A and Part B) will typically cover hip replacement surgery if it's medically necessary. Also, the surgeon said that I would end up having one leg shorter than the other is this true? I am about 5 6 and 185 lbs, age 58, he did not think the weight was an issues. If you would like a personal consultation, please contact our office at 954-489-4584 or by email at LeoneCenter@Holy-cross.com. Finally, many people who are struggling with hip disease experience lower back pain or even sciatic discomfort. Dr Leone, you make the point several times that the surgeon, not the procedure is most important. There are a few disadvantages to hip replacement surgery. Losing weight and strengthening your muscles pre-operatively will make surgery easier and greatly facilitate your rehab. In has been my experience in life that if others are happy and had a good experience then that speaks strongly to me, if I were to do the same thing. Im 56 years of age, 6 1 and 180 pounds. My surgeon does the SuperPath method. My first bike ride was 22 miles without any problems. Some people also tend to form scar tissue and contracture more readily than others. Is AL better than P for this? 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. There are a few disadvantages of anterior hip replacement that patients should be aware of before undergoing the surgery. Do you also do arthroscope surgery? I would discuss fully your goals and concerns. When discussing the options, my surgeon all of a sudden suggested performing anterior approach. This complete wall of tissue that surrounds the new hip imparts stability. Any info would be appreciated. I play in the 50s age group. The pain in my hip is strange in that I can hike uphill and down hill, bike and X-country ski but have a very hard time walking on the flat, especially after sitting for awhile or getting out of bed. A hip replacement is a common type of surgery where a damaged hip joint is replaced with an artificial one (known as an implant). You are here: Home 1 / avia_transparency_logo 2 / News 3 / disadvantages of superpath hip replacement disadvantages of superpath hip replacementtesla floor mats, model y June 7, 2022 / kimt contest page / in are dogs allowed at schoetz park / by / kimt contest page / in are dogs allowed at schoetz park / by THR if a MRI or Pet Scan isnt done? 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. These are all realistic goals. I am a sixty five year old active male and need THR on my right hip. I also have undiagnosed neuropathy in both legs from the knees down. Thanks again for this great blog! superpath total hip replacement animation - YouTube Driving hurts too. I have seen 2 doctors one doing posterior, the other anterior. They may have a certain cut-off criteria (for example, a BMI of less than 35). It is important to understand that "less invasive" does not only refer to the incision but . The SuperPath procedure was designed to replace the joint while sparing as much tissue as possible, substantially improving patients' recovery time. Years!! Can you suggest any pain medication that would not interfere with anti rejection drugs? Its been 9 months(Ive had it 2xs bf and got rid of it and have tried everything and no results this time). Once youve decided, you then need to trust that he or she will take the best care of you possible to deliver the best results. Its reasonable to inquire about his or her experience using the Mako robot. Your blog on anterior vs posterior approach was very informative. What to Expect more nutritious, too. In my last blog post, I discussed minimally invasive surgery with regard to hip replacement. Had a total hip replacement aug 2013. 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. 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. The first surgeon never mentioned this condition at all. A neurologic evaluation is appropriate to rule out reversible causes, but most work-ups do not elicit the exact etiology and usually symptoms only can be managed at best. I wish you a full and speedy recovery. Since I previously had both knees replaced (by another surgeon) about 5 years ago and still have problems with the knees i.e. The bone isn't dislocated in surgery. I began using the superior approach for total hip replacement in February of 2014. . If a mini posterior approach is used and the resultant total hip has optimally positioned components and balanced soft tissues, and was implanted through a smaller incision with less underlying soft tissue dissection and trauma, then I believe it is a benefit. The most important decision you must make is choosing your surgeon. 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. 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. Its been 8 months now. SuperPATH showed better results in decreasing operation time, incision length, intraoperative blood loss, and early pain intensity. After reading your article I see there are many reasons to go with the posterior approach but nothing about having to use a smaller prosthesis with the anterior approach. The second most-common injury is to the femoral nerve. These cookies are strictly necessary to provide you with services available through our website and to use some of its features. I had good results into 5th month post op and then everything went downhill. Each question is scored from 1-5, with 1 being no problems and 5 being severe problems. It is important that you find a doctor who is experienced in caring for people with complex issues. Further, I would contact your insurance carrier and the hospital so you will not be surprised with any unexpected costs. The particular surgeon who did your hip is also uniquely qualified to advise you with regard to the postoperative stability of your particular hip, because he or she physically tested your hip intra-operatively. As noted above, because the femur is difficult to visualize, component positioning, sizing, and stability are more likely to be compromised. I prefer spinal anesthesia when possible because fewer drugs are used and often the experience is gentler. There is also a small risk of infection at the surgical site. I love that you take time off to reply to these messages it is commendable. It typically requires a 4 to 5 day hospital stay, 3 to 6 month recovery period . The anterior approach has a lower incidence of sciatic nerve injury and a higher incidence of femoral nerve injury. The most important decision you will make is choosing your surgeon. Dr. William Leone, Hello Dr. One advantage the ceramic-on-polyethylene carries is the lack of . A hip replacement involves removing the ball (femoral head) and replacing it with a metal or ceramic prosthetic ball. 4 mts later am using I will let you in on something personal. Getting those studies will not change the reality that you will need THRs. Every patient needs to have as limited an approach and dissection as possible that does not compromise the final implant position or create excessive trauma to the soft tissues. Tina, which procedure did you have? Currently we use standard ways, called either posterior or direct lateral approach. This is not true for bilateral cases. At the end of the day, I promise, it is not the approach but rather the person who is doing the surgery. 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!). A shorter hospital stay and faster recovery are typical of this because there is less damage to the muscles. It is not a substitute for excellent surgery. How does it affect the actual success of the Surgical Approach Types | Hip Replacement | Elvis Grandic, MD It does mean the surgeon has lots of room to move about though!! I have seen 4 surgeons. I would encourage you to discuss your concerns with you surgeon. I do not want the approach to dictate the optimal construct which I hope will last 20 years and more. I would look at the published track record of the hospital where the surgery is scheduled to be sure its performance record is good and its incidence of infection is low. Im so pleased to learn that you had a good experience. As a result, patients can return to their normal activities much sooner than if they had had traditional hip replacement surgery. (PATH) and Supercapsular percutaneously assisted total hip (SuperPATH) arthroplasty: learning curves and early outcomes. I have read your articles about procedures (anterior vs posterior). 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. Patient is a UK registered trade mark. If was 3 weeks after discharge In the United States, a traditional posterior approach is the most commonly used. However, I now have quite severe OA in my right hip apparently I have no cartilage left and have been told by a surgeon that I am just lucky not to be in constant pain. Fort Lauderdale, FL 33334 Anterior vs. Posterior, Posterior vs Mini-posterior. When a patient feels better, they can return to work almost immediately, though it usually takes two weeks or longer. A number of patients who have undergone this procedure are able to walk unassisted the day after surgery . I needed no physical therapy at all. The size and placement of the incisions will be different. I would rather my patient get half as much anesthesia. Minimally invasive versus standard incision anterolateral hip replacement: a comparative study. I also think infection must be investigated and ruled out. I would emphasize choosing your surgeon and not the approach. Hips that are out of joint have an anterior hip replacement. I have congenital hip dysplasia which has gradually caused more pain as Ive gotten older. A major hip replacement can take up to four months to fully recover from. It is critical that the patient is aware of the risks, benefits, and alternatives of the procedure. Surgical Techniques An artificial joint is used to replace the worn out hip joint during a hip replacement procedure known as posterior hip replacement. My question is, what will my restrictions be? I understand and respect that many surgeons prefer doing them simultaneously. Always speak to your doctor before acting and in cases of emergency seek Woke up with I also think its reasonable to look forward to returning to all of the listed activities that you enjoy. J Bone Joint Surg Am. (I have SCD) It has now become unbearable and I am preparing for surgery. If you were in Los Angeles and needed a THR who would you choose to do your surgery? but it was more torn than they thought and they had to cut out about 1/4 of it. Thank you for all you do and for providing me with the information when I needed it. What is your experience and take on this ? I am a 53 year old active, distance runner. The first is that it is a major surgery, so there is a risk of complications such as infection. Can you explain this approach? SuperPATH Total Hip Replacement Phoenix, AZ | Total Hip Replacement Arizona We now have less-invasive techniques, better surgical methods of closing soft the tissue and more experience. Bleeding at the operative site can occur as a result of an anesthesia reaction, such as an allergic reaction. There does appear to be an increased incidence of stem instability when implanted through the anterior approach, but I believe this is largely a function of the surgeon experience. I am experiencing pai. The physical build of some patients increases the difficulty. Super path appears to come with it's hazards due to bone sawing rather than dislocation of the hip to be replaced, making revision much more difficult if issues occur later down the line. It is important to consider the SuperpathTM technique if you are considering a hip replacement. We now have too many other proven bearing surfaces available. The Pros and Cons of Two Approaches to Hip Replacement: Mini-Posterior There are potential drawbacks to anterior hip replacement. 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!" I am wondering if having mild hip dysplasia is a factor in which approach is used. Very sorry to hear of the difficulties you experienced! Thanks. Though the duration of your hospital stay can vary, many patients having hip replacement surgery don't need to stay in the hospital very long. Having diabetes and two organ transplants does significantly increase your risk for post-op infection as well as other complications. Since my acetabulum is too shallow, and other angles are off as well, how does the new cup get positioned correctly? Advantages and Disadvantages of Anterior Hip Replacement I often suggest to my patients that they speak to other patients for whom Ive cared and to whom they can relate to learn about their experiences. About how much does this cost? Most doctors have and continue to implant hips through the posterior approach. What is SuperPath hip replacement? The Pros and Cons of Two Approaches to Hip Replacement: Mini-Posterior https://holycrossleonecenter.com/wp-content/uploads/2018/12/Screen-Shot-2018-12-10-at-3.48.24-PM.png, https://holycrossleonecenter.com///wp-content/uploads/2017/11/Leone-Center-Logo@2x.png, The Pros and Cons of Two Approaches to Hip Replacement: Mini-Posterior and Direct Anterior, Copyright 2018 - 2023 The Leone Center for Orthopedic Care. More likely, its because ones activity increases after the first THR. . Really Great. Ive never foulnd information from any doctor or research-site but that there is always no legs-crossing, no more than 90-degrees (for the most part), and no twisting for anything but full Anterior. It's cut off and removed through the hole. I find that patients who are well informed and know what to expect prior to surgery get well even faster. I have a tilted sacrum, sway back and a very large posterior. I feel that at 10 weeks with profuse denervation potentials on the quad muscles, the prognosis is not good, even at 6 months. Procedures Back to work/driving in 10 days. During anterior approaches, fracture repair is much more difficult and necessitates the use of a separate incision. and Privacy Policy and steps will be taken to remove posts identified The idea is it should be a little less painful if the muscle, tendons and nerves are not disturbed. There are many benefits to posterior hip replacement surgery including a quicker return to daily activities, a more natural feeling hip joint, and a decreased risk of dislocation. Your article has made it clear I made the correct decision, especially since my daughter had nerve damage from an operation years ago. I decided to stick with my trusted orthopedic surgeon (who did two knee scopes on me) who believes the minimally invasive posterior approach is the safest approach. However disadvantages include the inability to adjust for leg length differences and a relatively high risk of femoral neck fracture. The first step to rule out infection is to have two simple blood studies done, an ESR and CRP. This technique is also referred to as the . 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. 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. Does my prothesis not last as long since I am now doing a 3rd surgery? Patient Resources However, some offer greater patient benefits than others. A modern artificial hip joint is designed to last for at least 15 years. I would like your opinion on the stem cell injections as I am really afraid of the second surgery on the same side of my body. Behavior. Choosing a surgeon based on his or her experience and complication rate also is exactly right., My strong advice is to choose your surgeon, not the approach. The intended interval between the front thigh muscles can be difficult to recognize and there has been an associated increase in injury to the femoral nerve or vessels. Posterior or Anterior? Femor fracture. Thank you for this! No, I would not tolerate the pain and immobility, if there is a reasonable way to relieve it. The anterior approach is not as muscle sparing as some would argue. disadvantages of superpath hip replacement It allows the surgeon to work between the muscles and tendons without removing them from their anchoring points on the hip or thighbone. The healing and maturation of this tissue takes time. Intervals between muscles are separated or muscles are separated in line with their fibers without injuring the muscles innervation. If a patient has abnormal anatomy (such as dysplasia, posttraumatic arthritis, or morbid obesity), or if their body mass index is higher than 35, it may be impossible for them to be considered for direct anterior surgery. During the hip replacement procedure, the surgeon makes a small incision near the front of the hip to allow for the removal of damaged anterior bone and cartilage, as well as the implantation of an artificial hip without damaging the surrounding muscles and tendons. I'm hoping to read some posts post surgery. How long will my hip replacement last in your opinion? Also, since I am only 51, I am concerned about component longevity. Also, only a small percent of C-on-C bearings are being implanted at this time. It is not acceptable to lean forward while sitting down or standing up, and it is not acceptable to bend past 90 degrees (as shown in the angle in the letter L). SuperPath approach uses about a 3-inch incision at the side of . 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. Hip replacement via SuperPATH approach had a longer operation time than hip replacement via conventional approaches. Thanks so much for this information! There arent any activities that you can do with a resurfaced hip that you cant do with a total hip. If I have a 2nd revision of my right hip is it posterior approach or the mini-posterior approach as you discuss above? 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? I had no inkling of this till he showed me on the x-ray. Historically in my practice I performed many Bilateral THR and TKR and have backed away from that practice. Its been my experience that femoral nerves tend to recover more readily than sciatic nerves. Not only was my recovery twice as fast with the anterior, there was very little pain in comparison. With SuperPath, there is no surgical dislocation of the hip. Had horrible groin pain issues and opted for the antior, I knew of nothing else as I consulted with a surgeon who was trained in anterior. The traditional posterior approach is the most commonly used in the United States and throughout the world (about 70 percent).
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