This treatment is much more definitive and predictable. I had an MRI by a different hip doctor (a preservationist) who diagnosed me with a birth defect (hip dysplasia). My surgeon wants to use the posterior approach and indicates that I eventually should be able to play golf again. There are numerous complications associated with hip replacement surgery, but blood clots in the legs and hips are two of them. Because of this, when you're ready to get up and walk about again, engaging your muscles and hip flexors might be extremely tough. A hip replacement is the most common cause of complication in about 20% of cases. My question is, what will my restrictions be? This suggests that something changed after five months. Thank you so much for your answer, I appreciate your taking the time to care about others. I also would learn about the track record of the surgeon and hospital where you will decide to have the surgery and what implant will be used. We provide you with a list of stored cookies on your computer in our domain so you can check what we stored. This too will lower your anxiety and improve your experience. I never seem to know when I am going to get hit with pain. If this occurs, the patient may experience pain and swelling. Other jobs, which tend to be more structured and / or more physical, may require more time off. Every prosthetic joint has a mechanical range of motion. General comments will be answered in as timely a manner as possible. I do not want the approach to dictate the optimal construct which I hope will last 20 years and more. I was told to wait 6 weeks before I resumed my exercise regiment. It's a hip replacement surgery where you lie on your side. disadvantages of superpath hip replacement. For centers like Phoenix Spine and Joint that use a robot, there is . These other conditions need to be defined and hopefully ruled out as the primary source of pain. The surgeon will be building a construct that hopefully will last her life time and change her life profoundly. Can you suggest any pain medication that would not interfere with anti rejection drugs? I went with a total hip replacement. Additionally, people with certain health conditions such as diabetes or heart disease may also not be good candidates. 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 . I am just under 5 ft and weigh 185. I would suggest seeking out doctors who specialize in hip replacement surgery rather than general orthopedics. 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 initial recovery period typically takes six weeks or more. Im now 6 weeks out and doing good. I also regularly receive Rolfing treatments which has helped me manage pain and maintain what mobility I have. If you have these arthritis symptoms, you should consider a hip replacement: severe hip pain that is not relieved by medication and that interferes with your work, sleep or everyday activity hip stiffness that restricts motion and makes it difficult to walk To learn more, read Here's What to Know if You Think You Need a Hip Replacement. July played my last match when I buckled. Our team of experts, doctors, and orthopedic specialists are here to share their knowledge and experience with you in order to help you make informed decisions about your health and well-being. Also, after an accident, I had 12 screw and an L shaped plate in my heel. 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. Studying a hospital and physicians track record before you commit is important. As for doctors, the surgeon I had came highly recommended. Sometimes during surgery it is necessary to release particularly tight structures to expose the joint for reconstruction or to better balance surrounding soft tissues after reconstruction. 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. Honestly, most 59-year-old active women do best with a well done THR. On July 17th, I had a left THR. The only problem Ive had post hip replacement is some on/off again groin pain. The doctor is planning a traditional posterior. 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. Both of these are very successful ways of doing a hip replacement. How would a hip replacement be done? emergent norm theory quizlet. A hip replacement is a common type of surgery where a damaged hip joint is replaced with an artificial one (known as an implant). My surgeon does the SuperPath method. If you do not have a hip replacement, you will live a sedentary lifestyle and become overweight. I have many patients who are accomplished and passionate ballroom dancers. What surgical approach is typical for a complex total hip replacement? That's all I know. In my experience, the restrictions (or those positions we ask our patients to avoid after surgery) have become much less limiting and are off limits for a much shorter period of time. SuperPATH showed better results in decreasing operation time, incision length, intraoperative blood loss, and early pain intensity. not moderated or reviewed by doctors and so you should not rely on opinions or advice given by other users in Being out of bed and moving soon after surgery adds to a patients safety and speeds the recovery. I am unsure whether the minimal invasive posterior is available in SA. Depending on the degree of injury, you may need a knee brace to lock you knee in extension when walking until the quad function returns. [QxMD MEDLINE Link]. Publications Most individuals who have had total hip replacement surgery fall into this category and simply resume their lives.. 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. There are a number of different potential surgical approaches available for hip replacement, each with their own potential advantages and potential drawbacks. Really Great. I have had problems with my hip for the last several yrs. In 2014 I had to do another THA, this time on my right side. 3. As long as you do the necessary surgeries, you will eventually break your femur, but only if you do enough. A miniposterior approach uses the same intervals as the standard posterior approach but simply less tissue is released for the exposure. It is much better to precisely release and cut rather than tear or fracture. Its been 9 months(Ive had it 2xs bf and got rid of it and have tried everything and no results this time). Why would the doctor not have that at their finger tips? Many also mate this with a ceramic femoral head. Over the years, these precautions and the length of time to adhere to these limits have been challenged both by clinicians and patients. Intervals between muscles are separated or muscles are separated in line with their fibers without injuring the muscles innervation. 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. A lot of hospitals and ambulatory surgical centers offer what's called outpatient surgery. Original Medicare (Part A and Part B) will typically cover hip replacement surgery if it's medically necessary. The nerve which supplies sensation to the front and side of the thigh is vulnerable. 4. Surgical Techniques One advantage the ceramic-on-polyethylene carries is the lack of . Hip pain, soreness, and stiffness can quickly become unbearable and sideline us from the things we enjoy the most. Overall, it sounds as if youve had an excellent result and wonderful recovery following your hip replacement. Back to work/driving in 10 days. This is used when the cartilage in the hip is severely damaged by osteoarthritis or other conditions. Our overall findings suggested that the short-term outcomes of THA through SuperPATH were superior to DAA. Click to enable/disable _gid - Google Analytics Cookie. 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. I was discharged within 24 hours. He treats a variety of hip, knee, and shoulder conditions, and performs hip and knee total joint replacements. Thanks. A modern artificial hip joint is designed to last for at least 15 years. appropriate medical assistance immediately. Until now. Dear Dr. Leone, If I have a 2nd revision of my right hip is it posterior approach or the mini-posterior approach as you discuss above? Gililand, our physician, explained the concept of health. Having physio Your blog on anterior vs posterior approach was very informative. There is a chance that the hip will fall out of the socket, or that it will be levered out by twisting it. 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 tore my labrum at age 43 and only discovered then that I had bilateral dysplasia. You can do anything you want after a hip replacement. What is most important is that you find a surgeon who understands the particular complexities with your problem and whom you trust. At the end of the day, I promise, it is not the approach but rather the person who is doing the surgery. Hip replacement via SuperPATH approach had a longer operation time than hip replacement via conventional approaches. Further, I would contact your insurance carrier and the hospital so you will not be surprised with any unexpected costs. Walking is the best exercise. Mayo Clinic researchers have studied ways to reduce blood loss, control pain and speed recovery for people who undergo hip replacement surgery. Most of my patients now go home the day after their surgery or the next. The bone isn't dislocated in surgery. I have done everything I can think of to preserve my right hip, but sadly this too needs replacing. There is a 1-2% risk of fracture of the femoral neck. If its a struggle, then the situation needs to be reassessed. You can check these in your browser security settings. A couple of things I am hoping you will explain using laymans termology. Not putting you on the spot, but would it be advantageous for me to drive 200 miles to have a consultation done by you? Talked to my foot doc and we decided on the Topaz procedure which has good results. My surgeon is doing posterior and my reason is I am self employed with limited Time off available and hope to be back to work at least walking and driving in 4 to 5 weeks is this possible? I very rarely transfuse any patients now. Most doctors have and continue to implant hips through the posterior approach. I dont think there is one best prosthetic. Some have features that are more suited to one persons anatomy and needs than others. The pain I get is in the groin and a sharp pain in the buttocks, that feels like muscle pain. 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. The highly crossed linked polyethylene liners are now the gold standard in this country. A major muscle is not cut during anterior hip replacement surgery, so pain is reduced and major muscles are not cut after the operation. Click to enable/disable Google reCaptcha. I was out of bed walking around the evening of the surgery . Had a total hip replacement aug 2013. Historically in my practice I performed many Bilateral THR and TKR and have backed away from that practice. 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. My mom is obese, short and has osteoporosis. Posterior or Anterior? 3. The anterior approach exploits an interval between muscles that cross the front of your hip and thigh. In the front of the hip, fewer muscles are present, so the surgeon works between them instead of cutting through them and then detaching them (and then repairing them after the surgery). The leg lifts really aggravate the front of the hip. 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. General comments will be answered in as timely a manner as possible, Hip & Knee Surgery 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. In severe cases, I will use my patients own femoral head, which is removed as a bone graft to help stabilize the new cup and garden new bone for the future. I would recommend having an honest discussion with the surgeons you are considering. Complications By 2016 and over 300 SuperPATH cases, the results of very first 100 SuperPATH surgeries (the so called 'learning Curve') were published in a peer reviewed journal with . My question is, I am a very active 67 yr old. For many years, I performed bilateral THR and bilateral TKR procedures, but have backed away for a variety of reasons. Going in for THR in July. A femoral nerve injury is devastating and is more vulnerable during an anterior approach than with other approaches. Surgical approach is important but its just one of many important variables. If you were in Los Angeles and needed a THR who would you choose to do your surgery? I walk a lot in my job and bend lots (work with children) and sitting causes pain due to impingement. The doc I saw yesterday said 4 weeks. 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 . Brandon Callahan, MD is a board-certified orthopedic physician with a decade of experience in providing comprehensive orthopedic care to patients with musculoskeletal injuries and disorders. I would look for a surgeon who is busy, has a strong track record and who practices at a hospital with a stellar reputation and where many joint replacement surgeries are done. The traditional posterior approach is the most commonly used in the United States and throughout the world (about 70 percent). I'm hoping to read some posts post surgery. It is important that these medical and cardiac conditions be optimized by your PCP and cardiologist preoperatively. Initially I was hesitant of THR thinking I was way too young for something so drastic but Ive now been miserable enough long enough that I am welcoming the idea of surgery. There is a possibility that blood loss may be reduced as there is less unnecessary exposed bone surface left to bleed. posterior surgery . Ann Transl Med. 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. The second advantage of a small incision is that it makes it easier to clean and care for the hip. More soft tissue trauma can result do to this increased difficulty in exposure and then gaining more exposure if necessary. Report / Delete Reply kelly1010 nicole66881 I was thinking of doing that 1st, maybe April(Ill be in boot 4 weeks), and then the PTHR in either Sept or next Jan when I have free time. 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 When discussing the options, my surgeon all of a sudden suggested performing anterior approach. Changes will take effect once you reload the page. If you would like a personal consultation, please contact our office at 954-489-4575 or by email at LeoneCenter@Holy-cross.com. Read our editorial policy. Thanks, This procedure differs from traditional hip replacements in the following ways: There is no surgical dislocation of the hip. I am experiencing pai. As a result of anterior hip surgery, there is little need for any special care. Specific protocols, therapy and what positions you will be asked to avoid after surgery and for how long will be directed by your surgeon. I already have an artificial knee that is doing great. 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. 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!" You should not proceed unless you know in your heart that you will be taken care of in a manner that has the best chance of giving you as perfect a result as possible. I had an anterior approach hip replacement. Sometimes the pain goes away as I walk and sometimes it doesnt. My surgeon uses the posterior approach. I then would strongly suggest you trust that person to decide what approach and what prosthesis predictably will deliver the best results. . We are an online blog dedicated to providing comprehensive and accurate information about orthopedics and injury prevention. With SuperPath, there is no surgical dislocation of the hip. thank you for your time. However disadvantages include the inability to adjust for leg length differences and a relatively high risk of femoral neck fracture. Click to enable/disable _gat_* - Google Analytics Cookie. Here are a few of the advantages of anterior hip replacement. She never though mentioned an increased risk of damaging femoral cutaneous nerve or possible muscle damage that would turn into improperly heeled muscle as a result. A orthopedic surgeon may insert a numbing agent directly into a new joint, which can last up to 48 hours. 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 surgeon accesses the hip joint from the front of the hip, rather than from the back or side. 1.2. Ken. I am 56 now and find that physical therapy and chiropractic care dont seem to be helping anymore. We provide the best cash prices and customer care in the industry. That means you have an excellent track record. Its been a couple months and I thought Id drop in with an update..over 4 yrs post op and I deal with Femoral nerve damage from Anterior, and found others who deal with the same.it may lessen with more years but who knows.Somewhere I read 15% or so end up with this..I talked 2 other people in my city, same surgeon and they have had this issue to. Other combinations of materials have advantages and disadvantages (for instance, some researchers believe that ceramic-on-ceramic types may be more durable, but they have also been known to make squeaking and popping sounds.) I would stay away from narcotics. July 2013 my left hip was scoped for a labral repair. Very sorry to hear of the difficulties you experienced! I still have some questions I hope you can answer as this is so distressful for me. I am a sixty five year old active male and need THR on my right hip. Many wonderful physicians are part of various HMO panels. My hope is that some of these symptoms will improve with time. Results of the surgery numbness in the right thigh, inability to stand on the right leg, muscle atrophy all confirmed by EMG and second orthopedic surgeon. William Leone. Personally, it I were caring for you, I would have advised you exactly as the orthopedic surgeon who took care of you did. The femur is prepared with the head and neck intact reducing the chance of fracture. I had an anterior right hip replacement in late 2010, I was 72. As a result, you are unable to pick up something from the floor or bend down to tie your shoes. Even after the procedure is completed and the patient is on pain medications, pain and discomfort may occur in some cases. 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. In another day I was able to take short walks without any limping, etc.. 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 determines the differences? Patients understand the risks that metal joints and sockets bring to their long-term health and are moving away from the material. Diagnosed possible labral tear. Click on the different category headings to find out more. An anterior hip replacement procedure, on the other hand, performs the same function as an anterior hip replacement in terms of tissue shaving. The anterolateral approach or Watson Jones approach is one of the classical hip approaches that can produce excellent results when utilized for THR. SuperPath hip approach. Because the patient is lying on his back during the procedure, fluoroscopy or moving x-rays are used to aid in the examination. Part of those possibilities includes a better and more comfortable sex life. The anterior hip can be easily and naturally recovered by walking, simple home exercises, and isometric exercises. The activity that I wish to have the most success with after the surgery is ballroom dancing. We are now in a situation where we have found two extremely good surgeons and we gel with both extremely well. Because these cookies are strictly necessary to deliver the website, refusing them will have impact how our site functions. After reading your article I am concerned about the issues you discussed. This technique avoids cutting muscles and tendons, minimizing surgical trauma and improving the post-operative experience. I sit on a cushion in the car to lift me up. I began using the superior approach for total hip replacement in February of 2014. . Stay was 2.5 days. There is no way that you can recover fast from having bones cut and shaped and large metal objects inserted into them. I'm so encouraged to hear your successful story. This site uses cookies. 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. Would appreciate any input you might have on the auto immune issue, and weight etc. Therapy hopefully will help any contractures and scaring within your muscles that might have developed after surgery. 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