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. results, I decided to see and orthopedic doctor was advised to have THR. According to Dr. Gililand, patients should not try to change their surgeons opinion based on their preferences. Patient Resources Anterior hip replacement is a type of hip replacement surgery. Pain is almost gone and I am beginning to get back to my life. I, too, am struggling which approach to have. Disadvantages of the anterior approach include: The nerve which supplies sensation to the front and side of the thigh is vulnerable. It exploits the inter-muscular interval between the tensor fascia lata and the gluteus medius. Is it really as good as it sounds? But I feel that time could be lost and all my symptoms may become irreversible. I think it perfectly ok to discuss different approaches and ask for an opinion. I dont want a long recovery time as I am very active. The anterior approach, as opposed to the lateral or posterior approach, uses a small incision in the front of the hip. I had the mini posterior approach done and it gets better everyday. What do you mean by painful anterior scarring and soft tissue exposure and trauma? You can check these in your browser security settings. Time will tell if this generation of shorter press-fit stems fares as well. Soft tissue contractures often are associated with long-standing arthritis. In general, I would encourage you to consider all of your prosthetic joints a remarkable modern day miracle that must be cared for and respected. The activity that I wish to have the most success with after the surgery is ballroom dancing. A hip replacement is a common type of surgery where a damaged hip joint is replaced with an artificial one (known as an implant). 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. Sitting seems to irritate it the most. Do either of your techniques require the traditional anterior or posterior precautions? Publications Blood clots or bleeding. I wrote to you in January, now my surgery is in a couple of weeks. This surgical procedure is performed with a patient lying on their side, and a surgical incision made along the outside of the hip. I saw a hip surgeon last year for an opinion, but because I had almost no arthritis on the x-ray he said he saw no need for surgery. Being out of bed and moving soon after surgery adds to a patients safety and speeds the recovery. Risks associated with hip replacement surgery can include: Blood clots. Each surgeon approaches these issues individually. Do you agree? If you have an abnormal anatomy or are morbidly obese, you may not be a good candidate. Remember, what youre hoping to do is have a hip construct that will last 20 years or more. This can cause you persistent pain, stiffness . Because of the marked improvement in modern plastics, there is greater longevity and durability of acetabular plastic liners and larger femoral heads are used routinely which results in an improved the head/neck ratio and therefore the jumping distance for a hip to dislocate. Patient does not provide medical advice, diagnosis or treatment. Help. I, personally, have not had a patient dislocate following a primary total hip replacement in many years. 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. I wish you a full and uneventful recovery. Because my husband has circulation problems in his leg and vein removed for open heart surgery last yearhis surgeon recommended the Mini posterior surgery. It typically requires a 4 to 5 day hospital stay, 3 to 6 month recovery period . It would be interesting to hear what you have to say Doug. I assume its something near my groin. Irrespective of the approach that is used to implant the prosthesis, the tissues that surround the new prosthetic hip must heal and mature if the hip is to achieve stability. 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. When a patient feels better, they can return to work almost immediately, though it usually takes two weeks or longer. Finally, hip replacement surgery is expensive and may not be covered by insurance. 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. emergent norm theory quizlet. Pain Management Recovery time for anterior hip replacement is typically two to four months, and recovery time for posterior hip replacement is typically four to eight weeks. To have your other hip replaced through a different approach is a decision you need to make with your surgeon. Also congenital pulmonary hypertension (PA pressure about 52) and have hashimotos hypothyroid, and two additional auto immune issues ( alopecia and psoriasis of feet),and hypertension. I did have numerous blood tests, MRI of knee and hip, total body scan with radio active injection, X-ray knee and hip etc. I would encourage you to discuss your expected recuperation time and specific restrictions with your surgeon. These are all realistic goals. If you are minimally handicapped with discomfort from the non-operated hip and the leg length difference is tolerable or easily managed with a shoe lift or modification, I would consider waiting. When compared to the anterior approach to hip replacement, which is typically more painful, there are several advantages to recovering from an anterior approach, including the fact that you will not be required to follow any specific anterior hip replacement precautions, such as bending or crossing your leg. My question is, what will my restrictions be? My acyive 60 year old husband is scheduled to have Mini posterior total hip replacement in 6 weeks. It is not a substitute for excellent surgery. I have been told that I can fly 48 hours after surgery?? The surgeon I am meeting with (Dr Jimmy Chow) is supposed to be top notch in this procedure, and I am just curious as to how different the surgery is from conventional surgeries. My main concern is that I have a tilted sacrum and a very sway back. I am 63 years old, 54, 115 pounds. I think cutting muscle was in the past. Getting those studies will not change the reality that you will need THRs. I have never operated on another surgeon who asked me to make as small an incision as possible or use the minimally invasive approach. I have done everything I can think of to preserve my right hip, but sadly this too needs replacing. The most important decision you must make is choosing your surgeon. I have had both hips replaced about 13 months apart, one anterior and one posterior, and there is no doubt that I would recommend anterior. When performing anterior anterior reconstruction, these patients frequently have very short stems that are inserted into the bone. This risk is greatest in older females with bone of sub-optimal quality. Mini posterior refers to the approach or tissue interval the surgeon uses to implant the Total Hip. Fortunately, many folks who experience back symptoms before THR report improvement or resolution after. Femoral nerve function also should be assessed. While it is a surgery that does help many, many people, clearly you are struggling. A metal or plastic implant is used to replace a damaged or diseased hipbone. Im considering this mini posterior approach. Because the patient is lying on his back during the procedure, fluoroscopy or moving x-rays are used to aid in the examination. I am 5 weeks out and have been doing beautifully! Our insurance covers both. I began using the superior approach for total hip replacement in February of 2014. . 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. Finally, hip replacement surgery is expensive and may not be covered by insurance. No, I would not tolerate the pain and immobility, if there is a reasonable way to relieve it. SuperPath hip approach. What are your thoughts with regard to Stem cell therapy in lieu of THR? Most receive a simple spinal with sedation. I seem to be able to hike just fine up hill and down but not always on the flat. My walking is very limited, shoe is built up as leg is shorter and in recent months Ive realized my leg is bowed. Thank you for sharing. If they are really happy, then you probably will be as well. With degenerative osteoarthritis of the hip developing secondary to a severe slipped capital femoral epiphysis (scfe), recreating normal hip mechanics after THR may have necessitated lengthening the first hip. 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. Currently we use standard ways, called either posterior or direct lateral approach. I definitely didnt have any tendons or muscle cut and was cycling on the road from day 12 and back running at week 4 . Dr. Sigmund holds a subspecialty certificate in Orthopedic Sports Medicine. Felt very uninformed and left When the joint is held together by gravity and asymmetric anterior muscle tension, the tension between the ball and socket may change in various directions. Better luck to you all. I would rather my patient get half as much anesthesia. Fortunately, if the components are stable (bone-in grown or cemented) and optimally positioned, and the surrounding tissues has fully healed and matured, then that risk is very small. Obese or extremely muscular people may not be the best candidates for this surgical procedure. (I have SCD) It has now become unbearable and I am preparing for surgery. There is also a small risk of infection at the surgical site. Ive come to the conclusion that perceived benefits do not outweigh the risks with the anterior approach, especially when I can achieve the same or more using the mini-posterior. An anterior-approach hip replacement necessitates a small incision in the groin area on the front side of the leg. Start your day off right, with a Dayspring Coffee If theyre really happy and got well quickly, you probably will too. I am scheduled for total hip replacement in about 3 weeks, and none of these procedures/options were discussed with me.the surgeon just said that it was a risky surgery and he could not guarantee anything! These scores are not aggregated. Thanks. Thru X-rays Ive been told both hips are bone on bone! Yes, Im angry. The rule of thumb is that recovery occurs over a 12-18 month period following injury. No special surgical equipment is required when performing a mini posterior. The pain is really inconsistent, one min I will be walking fine and the next it catches and is very painful, then it may go away or may not. Six weeks or longer is the exception. SuperPath hip replacement is a newer method and has been used since 2019 at Leicester's Hospitals. I deal with major nerve damage on front of thigh, almost whole thigh. 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. I take care of many individuals who have a total knee and hip replacements on the same side. Pain and disability are reduced. Total hip replacement is one of the most successful operations ever developed and is a remarkably predictable way to relieve pain from arthritic conditions. There are a few disadvantages to hip replacement surgery. This technique avoids cutting muscles and tendons, minimizing surgical trauma and improving the post-operative experience. I believe this is an important discussion you should have with your surgeon preoperatively. Enhanced soft tissue techniques also have been developed which more securely close the tissue around the newly placed prosthesis and set the stage for healing. 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. 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. Complications Thanks, Before proceeding, it is a good idea to review the recommendations and specific parts that your surgeon may recommend. Can you explain it to me as he didnt go into detail. This does expose the patient to more radiation but can help with component positioning and sizing. Hip replacement is the second most common type of joint replacement, trailing only total knee replacement. A THR is in my future. Fortunately you live in a part of the world where there are many capable orthopedic surgeons. Due to security reasons we are not able to show or modify cookies from other domains. Thank you for this information. Changes will take effect once you reload the page. Some surgeons will use 2 incisions, both the anterior and superior approach. Many wonderful physicians are part of various HMO panels. 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. Hip anatomy Finally, in July 2013, the first SuperPATH Hip replacement in Australia was performed in Nepean Private Hospital, Sydney. Until now. The other things that can affect the op is your fitness beforehand, your attitude and your age, although you may have difficulty getting younger!! I also would find out your surgeons recommendation regarding activities and restrictions. Long-term outcomes of SuperPATH approach need to be investigated. The SUPERPATHTM procedure provides a number of advantages over traditional hip replacement surgery. Does my prothesis not last as long since I am now doing a 3rd surgery? Over the last six years, I have performed more than 2000 primary or first-time total hip replacements using the mini-posterior approach and I am aware of only one patient who dislocated his hip because he fell down stairs. Because the mini-posterior is more straightforward, many surgeons think it provides an increased margin of safety for the patient, because the incision can easily be extended if exposure is poor, or if a fracture occurs.
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