I am scheduled to have total hip replacement surgery in 2 weeks. Some surgeons will use 2 incisions, both the anterior and superior approach. When performing anterior anterior reconstruction, these patients frequently have very short stems that are inserted into the bone. Finding the right surgeon is critical, because your care is about so much more than just fixing your hip. #1. Once again, it sounds as if you had a wonderful surgeon, which is the most important variable. Because I have scfe also in my left hip, I will have to have it fixed too. Dear Dr. Leone, Introduction. We fully respect if you want to refuse cookies but to avoid asking you again and again kindly allow us to store a cookie for that. 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. Its been my experience that femoral nerves tend to recover more readily than sciatic nerves. It is important to understand that "less invasive" does not only refer to the incision but . I am now 59, still in good condition but that is being compromised by lack of working out as my hips get sore from most everything I try. 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. appropriate medical assistance immediately. Reconstructing the opposite hip hopefully will result in legs that feel more equal. Lift your knee rather than your hip at the same time. Hip pain, soreness, and stiffness can quickly become unbearable and sideline us from the things we enjoy the most. Better luck to you all. This often leads to a less than optimal component position. My strategy is to make as small an incision as possible, but one that allows for excellent exposure and reconstruction without brutalizing the tissues. Robert H. Sigmund, MD | Signature Orthopedics Kenneth, You saw me in your office yesterday (I am 48 years old) as I had complications following a THR of right hip anterior approach with revision 4 days later for a slipped acetabular and then last week I had a dislocated hip. 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. We provide you with a list of stored cookies on your computer in our domain so you can check what we stored. The idea is it should be a little less painful if the muscle, tendons and nerves are not disturbed. There are a number of different potential surgical approaches available for hip replacement, each with their own potential advantages and potential drawbacks. Once again, I think your decision to proceed with THR is the most reasonable. Dear DR Leone, I dont know what type of procedure was used for my first op but it was sucessful and now can do a half lotus position with no problem.I do find however that the muscles at the front of that leg are not as strong as my unoperated right leg and lifting the left leg to a vertical position in yoga, when lying on my back, is quite difficult. Are these expectations realistic? Hello Dr Leone, If a revision were necessary, even more bone must be destroyed to remove it. 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. 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. Many patients approach this by researching online and speaking to other patients who have been cared for at a particular facility. I had posterior and much like the superpath trussed into the jig . DAA had a lower rate of hospitalization and functional rehabilitation as compared to the lateral approach, as well as a lower perceived level of pain. 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. The first is that it is a major surgery, so there is a risk of complications such as infection. 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). I wish you only the best. Every prosthetic joint has a mechanical range of motion. There is some concern that this weakens the abductor and leads to a limp. Years!! 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. There are a few disadvantages of anterior hip replacement that patients should be aware of before undergoing the surgery. Many of these stems have very little if any long term follow-up, although some appear to be doing well in the short term. Both of these are very successful ways of doing a hip replacement. Optimal component positioning also is critically important for the best stability and longevity. Dear Dr. Leone, Because the patient is lying on his back, it facilitates using a fluoroscope or moving x-ray throughout the procedure. Many studies suggest that any limp or clinical weakness resolves after approximately three months. This technique avoids cutting muscles and tendons, minimizing surgical trauma and improving the post-operative experience. Hip replacements might keep you out of action for a considerable period. 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 . That being said, if the foot is now a much bigger problem than the hip, you may have to deal with that first. Thank you. There is a possibility that blood loss may be reduced as there is less unnecessary exposed bone surface left to bleed. 5 Things to Know About Anterior vs Posterior Hip Replacement Also, be aware that as the nerve recovers, the smallest C fibers within the nerve recover first, which can cause a burning discomfort. Although Superpath hip replacement is often a safe treatment, it may be associated with certain concerns, such as increased postoperative pain, as with any surgical procedure. I would also like to know about the customized implant, as I havent yet heard much about it. I would love to hear some stories about the SuperPath hip replacement. 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. Total hip replacement is one of the most successful operations ever developed and is a remarkably predictable way to relieve pain from arthritic conditions. No Muscles Cut is for billboards. disadvantages of superpath hip replacement Therapy hopefully will help any contractures and scaring within your muscles that might have developed after surgery. Being discharged to a rehab unit is now the exception. Hip replacement - Wikipedia My husband has a plastic valve (done in 86) and synthetic assending aorta and triple bypass (done in 2013)very successful surgery. I really appreciate this website. What To Expect From Anterior Hip Replacement Surgery & Recovery Its been six months since surgery, my operating doctor keeps feeding me with lets wait another month stuff. There tends to be a lesser incidence of posterior instability with the anterior approach. I don't think there's a one size fits all when it comes to hip surgery. Even though I was positive I wanted this method done, I was still questioning my decision. I try not to bring up my mess but its hard when its with one 24/7. Woke up with Hip replacement surgery is typically performed in a hospital and requires at least one night in the operating room. Minimally Invasive Hip Replacement Procedure | Arthritis-health Everyone I know that has had both posterior and anterior surgery say not to even consider posterior. Mayo Clinic researchers have studied ways to reduce blood loss, control pain and speed recovery for people who undergo hip replacement surgery. SuperPath Hip Replacement (Surgery) : 3D Animation - YouTube The highly crossed linked polyethylene liners are now the gold standard in this country. Part of those possibilities includes a better and more comfortable sex life. Its from a malformation. That's all I know. The anterior approach, as a marketing tool, has grown in popularity among surgeons. You are free to opt out any time or opt in for other cookies to get a better experience. DePuy Hip Replacement - Overview of Complications, Lawsuits Hi, This complete wall of tissue that surrounds the new hip imparts stability. Thanks. (I have SCD) It has now become unbearable and I am preparing for surgery. 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. The nerve which supplies sensation to the front and side of the thigh is vulnerable. 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. Before proceeding, it is a good idea to review the recommendations and specific parts that your surgeon may recommend. Dear Dr. Leone, I am having Makoplasty ( robotic imaging) to my right hip in February. It would be interesting to hear what you have to say Doug. Once you find that doctor, then you need to put your trust in him or her to help you solve this horrible problem so you can return to being active and productive. My surgeon has told me I will need PT 3 times a week for 6-12 weeks is this too long? Risks of SUPERPATH hip replacement surgery Risks due to the surgery may include (but are not limited to): Pain Bleeding Infection Permanent or temporary nerve damage Extra bone or tissue damage Drop in blood pressure during the procedure Leg deformity Blood clot or clots (that could travel to heart or lungs) Delayed wound healing My advice would be to avoid the extremes of any motion that exceed your hips ROM. Original Medicare (Part A and Part B) will typically cover hip replacement surgery if it's medically necessary. A shorter hospital stay and faster recovery are typical of this because there is less damage to the muscles. Many times, the depth of the destruction that is found during surgery is much more advanced than initially anticipated, particularly as we age. The most important decision you will make is choosing your surgeon. Why would the doctor not have that at their finger tips? Dr. Leone, I am coming in to see you for an appointment for a THR to my left hip. Until now. General Information about Hip Implants | FDA Ten out of every fifteen hip replacements will be functional for more than 20 years after they are inserted. I plan to retire from working full time June 2017 and am concerned about having appropriate insurance after that. Dont let PR marketing confuse the big picture. Hip anatomy There is a chance of nerve injury with any type of hip replacement. If I think you may be a candidate, I will refer you to a doctor in our area that does. We want the forums to be a useful resource for our users but it is important to remember that the forums are 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 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. Tossed the cane at three weeks and went back to work. 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. We are always refining and trying to make it better. I am a!so told by the orthopedist who referred me that I need arthroscope on my right hip. The SuperPath procedure was designed to replace the joint while sparing as much tissue as possible, substantially improving patients' recovery time. I also think infection must be investigated and ruled out. Surgical Techniques Femoral nerve function also should be assessed. Fax: 954-489-4584 Blood clots or bleeding. It is highly recommended that you avoid bending your hips and turning your feet together as part of hip precautions. Hip Pain & Injury Care Sarasota, FL - Advanced Sports Medicine Raleighs orthopaedic clinic is board certified and has fellowship training in total joint replacement. 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. Email us. They may have a certain cut-off criteria (for example, a BMI of less than 35). Conclusions SuperPATH approach showed better results in decreasing incision length and early pain intensity as well as improvement of short-term functional outcome. You can resume your active lifestyle as soon as possible thanks to a new prosthetic hip. and Privacy Policy and steps will be taken to remove posts identified It sounds as if you had a wonderful surgeon. My question is, what will my restrictions be? However, some offer greater patient benefits than others. Because the femur is more difficult to expose during the anterior approach vs. the posterior approach, many surgeons will select a shorter femoral component to facilitate reconstruction and lessen chance of fracture. How Much Does Minimally Invasive And Robotic Hip Replacement Surgery My doctor does not do mini posterior, therefor I have a 6 incision. The hope is that your nerve injury will recover with time. I believe this is an important discussion you should have with your surgeon preoperatively. Also, is it immoral for an 80 year old to have THR and cost the nations health care system $25 $35k? Ill know a lot more after we meet and I review your X-rays. The anterior approach has a lower incidence of sciatic nerve injury and a higher incidence of femoral nerve injury. The following cookies are also needed - You can choose if you want to allow them: You can read about our cookies and privacy settings in detail on our Privacy Policy Page. What you can do is keep as good an attitude as possible and keep rehabilitating your leg. Click to enable/disable essential site cookies. I think its always beneficial to speak to other patients who have been cared for by that physician and learn about their experiences and results. What do you consider to be the most important factors in choosing a surgeon? The hip is replaced without the need for surgery to dislocate the joint. I have been told that I can fly 48 hours after surgery?? I am unsure whether the minimal invasive posterior is available in SA. There are a few complications that can occur with anterior hip replacement surgery. It is important that the individual who ultimately implants your next THR uses the approach which he or she feels comfortable with and has the best chance to deliver the optimal result. I advise both my total hip and my total knee patients to avoid repetitive impact activities like distance running. I find that patients who are well informed and know what to expect prior to surgery get well even faster. The hope is that these new designs will, but time will tell. 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. Time will tell if this generation of shorter press-fit stems fares as well. Posterior, mini posterior or anterior? Because of the concerns of posterior dislocation, in the past patients were taught certain positions to avoid. These positions include crossing your legs, bending your hip more than 90 degrees, or lying on your stomach. I dont know if this stems from the knee surgery but I do not believe so because I was well for about a year and a half. We thank you for your readership. I'm hoping to read some posts post surgery. Which approach did the doctor take? An anterior hip replacement is not covered by a specific credential system for orthopedic surgeons. Very few metal-on-metal bearings are being placed today due to the serious potential of metallosis. Advantages of an anterior approach to hip replacement A major muscle is not cut during the anterior procedure. A lot of hospitals and ambulatory surgical centers offer what's called outpatient surgery. Both approaches have been shown to have potential in research. The SUPERPATH technique is a tissue-sparing procedure. Thank you very much for taking time to reply me. I am terrified of nerve damage as I am very athletic and a previous professional ballet dancer. Almost all bilateral THR or TKR patients go to a rehabilitation facility after their acute stay, not home. Im so pleased to learn that you had a good experience. Tina, which procedure did you have? Most doctors have and continue to implant hips through the posterior approach. Having diabetes and two organ transplants does significantly increase your risk for post-op infection as well as other complications. After a slip and fall at work 2 1/2 years ago I need a THR on my left hip. Dr. William Leone. If your X-rays reveal that you already have bone on bone due to osteoarthritis, then you typically dont need either an MRI or Pet Scan, unless another diagnosis is suspected. I was so against doing this surgery but groin pain was very bad and crushed bone in the groin. The surgery time is much less with a single joint and therefore the sterile surgical instruments are opened and exposed to the environment for a shorter time. The surgeon I went to said he does THR using a lateral approach. My gait is off partially due to my hip but also I believe because of my body structure. I know the most important decision you will make is choosing the doctor who will perform your surgery. This interval must be developed and the muscles must be separated in order to reconstruct the hip. Hi Frances, did you have surgery posterior Superpath? I ride horses, water ski and kayak. I, personally, have not had a patient dislocate following a primary total hip replacement in many years. When the stem is placed in the femur, it still destroys the same amount of bone for implantation, regardless of which approach is used. After reading your blog Im thankful he suggested this approach. Do you have any thoughts on this issue? Yes, you do have increase risks. This can cause you persistent pain, stiffness . With a significant learning curve, it is likely that you will have to replace about 100 hips before you are truly comfortable with the approach. I suggest you discuss your concerns with your surgeon. I am a competitive tennis player in my age division. Between your legs, you should sleep with a pillow for the next six weeks. If you would like a personal consultation, please contact our office at 954-489-4584 or by email at LeoneCenter@Holy-cross.com. I believe going home is very therapeutic and often safer. If possible, try to get in writing any verbal promises made. I assume its something near my groin. Your article is the first Ive read in which no muscle or tendons are cut in any approach other than the direct anterior approach. No special surgical equipment is required when performing a mini posterior. I think stem cell injections will have little chance of doing any good if indeed your hip condition has already progressed to bone on bone. My advice is to focus on finding a surgeon with whom you are comfortable and have the best chance of doing well. not moderated or reviewed by doctors and so you should not rely on opinions or advice given by other users in Even in my practice, which is starting its 27th year, we continue to refine the surgical procedure, pre- and post-operative instructions and rehab (this is huge), pre- and post-operative pain management, and even anesthesia. The bone isn't dislocated in surgery. Do you also do arthroscope surgery? For risks she mentioned all the usual I knew about from the first surgery blood clots/loss, dislocation, etc.
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