I still have some questions I hope you can answer as this is so distressful for me. Soft tissue contractures often are associated with long-standing arthritis. Surgical Approaches To Hip Joint Dr. Apoorv Jain D'Ortho, DNB Ortho . General comments will be answered in as timely a manner as possible, Hip & Knee Surgery Because the anterior hip replacement surgery is a minimally invasive procedure, no cuts are made to the muscles surrounding the hip. It all comes down to the surgeons comfort as well as the patients. My worry is that I will end up with one leg shorter than the other. It is a mix of anterior & posterior. Intervals between muscles are separated or muscles are separated in line with their fibers without injuring the muscles innervation. 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. Original Medicare (Part A and Part B) will typically cover hip replacement surgery if it's medically necessary. I would stay away from narcotics. The surgical area of anterior hip replacement is located in the vicinity of the lateral cutaneous femoral nerve. As a result of this precaution, it is difficult to sit on low chairs, sofas, or toilets. Bleeding at the operative site can occur as a result of an anesthesia reaction, such as an allergic reaction. Orthop Clin North Am. . That means you have an excellent track record. A major hip replacement can take up to four months to fully recover from. The mini posterior approach essentially is the same as the traditional posterior, however a smaller incision is made and less soft tissue is exposed. In a posterior hip replacement, the procedure is done on the side of the hip. The traditional posterior approach is the most commonly used in the United States and throughout the world (about 70 percent). No special surgical equipment is required when performing a mini posterior. Thank you, Lisa Blumthal. Today, everything from tools to techniques has improved. Will I still be able to do the things I like to do? out the next afternoon and using a walking stick from day 2 to day 10 when I ditched it altogether . Choose your surgeon. [QxMD MEDLINE Link]. It is normal to want to recover quickly and return to a very active lifestyle without pain. 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. What is most important is that you find a surgeon who understands the particular complexities with your problem and whom you trust. I'm hoping to read some posts post surgery. The vast majority of my patients return to work one to three weeks post-operatively. Traditional Hip Replacement - Traditional surgery requires a large incision of 10 to 12 inches and detachment of muscles from the hip. Most importantly, I would meet with your surgeon and discuss all of these concerns. I am a South African and need to make a decision on whether my mother (69) goes for an AMIS or traditional posterior. Disadvantages of the anterior approach include: Although I am trained in both approaches and have trained surgeons in both approaches, I have stopped using the anterior approach because I saw my patients get well faster, bleed less, and have a more predictable result when I performed the surgery using a mini-posterior approach. You can resume your active lifestyle as soon as possible thanks to a new prosthetic hip. 2004 Apr. However, there are also some potential drawbacks to this type of surgery including a longer surgery time, a greater risk of blood loss, and a higher risk of nerve injury. It normally takes about 3-6 weeks to resume normal household activities and about 12 weeks to resume recreational activities like bicycling or golfing. Our clinical information meets the standards set by the NHS in their Standard for Creating Health Content guidance. emergent norm theory quizlet. In 2013 I had a THA done on the left hip. There is a 1-2% risk of fracture of the femoral neck. Surgical Approaches in Total Hip Replacement We are always refining and trying to make it better. My main concern is that I have a tilted sacrum and a very sway back. I have seen 4 surgeons. 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. That's all I know. Doc says once recovered I should avoid flexion with adduction and internal rotation. http://holycrossleonecenter.com/blog/hip-resurfacing-or-total-hip-replacement-a-candid-discussion/, http://holycrossleonecenter.com/blog/metal-on-metal-hip-replacements/, I wish you the very best recovery. This can cause you persistent pain, stiffness . Rush joint replacement surgeons are leaders in hip replacement surgery and research. It also helps to stabilize the acetabular shell and prevent soft tissue irritation on the out edge of the cup. Since my acetabulum is too shallow, and other angles are off as well, how does the new cup get positioned correctly? SuperPath Hip Replacement - SuperPath St Louis | Orthopedic Surgeons Also, in the U.S., nearly all stems which are being implanted through the anterior approach are press-fit rather than cemented. However disadvantages include the inability to adjust for leg length differences and a relatively high risk of femoral neck fracture. I understand they have good results in Thailand or India for half that. I was discharged within 24 hours. 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. I also think its reasonable to look forward to returning to all of the listed activities that you enjoy. One of the biggest changes that Ive seen in my practice over the past 25 years is how quickly patients get well and go home. Can I make an appointment with you. Surgical Techniques Should I be though? Maybe someday our nations health care system will measure up to that of France, Norway, Switzerland and others, in which their governments are investing half of the GDP that we are wasting. I'm hoping to read some posts post surgery. My recommendation is for you to discuss this with your surgeon if you have further concerns. Is it really as good as it sounds? Each question is scored from 1-5, with 1 being no problems and 5 being severe problems. Many believe that this results in less risk of infection. superpath total hip replacement animation - YouTube I had the posterior approach, the surgeon did not cut any muscle plus I had no pain at all after the op. In my practice, patients who undergo a THR using a mini posterior or posterior approach: 1. After reading your article on disadvantages of anterior approach and also doing extensive online search about this subject, I came to realize that anterior approach was definitely a wrong choice considering my physical build short, muscular, overweight. 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. Other health issues include congenital heart ASD corrected about 12 yrs ago with an amplatzer occluder implant by the right femoral approach resulting in possible femoral nerve compression, Lateral right leg numbness and leg discomfort since the implant, Groin pain and restriction in extending the right leg back has been a problem for some time and masked the fact that at least a portion of my increasing pain was from my hip. It is a pity that medicine cannot be as definitive as science but relies on historic figures and the future outcome appears to be a statistical probability! Hello Dr. Registered number: 10004395 Registered office: Fulford Grange, Micklefield Lane, Rawdon, Leeds, LS19 6BA. 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. There is a more than 200% chance of knee infection, most likely because the knee has more surfaces that can become infected with an infection. Why is that? Click to enable/disable _ga - Google Analytics Cookie. Consult your doctor to determine if joint replacement surgery is right for you. Minimally Invasive Hip Replacement Procedure | Arthritis-health Getting in and out of cars, and turning over in bed. DePuy Hip Replacement - Overview of Complications, Lawsuits Finally, because my patients are walking the day of surgery, most want to go home rather than to rehab. A number of patients who have undergone this procedure are able to walk unassisted the day after surgery . A typical recovery time from anterior hip surgery is six months. OTC nerve supplements suggested by a naturopath. All: Contact Dr. Moor, Orthopedic Surgeon at Advanced Sports Medicine Center. Thanks! Depending on the stability and range of motion observed at time of surgery, some doctors dont advise their patients to avoid any positions. 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 J Bone Joint Surg Am. We have an appointment today to discuss the plan of action. I have seen a number of patients who were reconstructed with the anterior approach who developed painful anterior scarring after the procedure. It is nice to see honest Q&A versus a marketing page. By continuing to browse the site, you are agreeing to our use of cookies. Posterior or Anterior? Have you heard of something like this, and if so, is it worth it? surgeons certainly do not go out of their way to cut anything, they move stuff about, if tendons do get damaged, it's more likely from the anterior approach as they have less 'sight' of the procedure due to the smaller incision. not moderated or reviewed by doctors and so you should not rely on opinions or advice given by other users in Minimally-Invasive Total Hip Replacement Surgery How does it affect the actual success of the 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. General Information about Hip Implants | FDA Advantages and Disadvantages of Anterior Hip Replacement I wish you the best of luck, I believe this is an important discussion you should have with your surgeon preoperatively. The socket of the pelvis is machined into a hemisphere and a metal hemisphere is inserted into the socket. As a result of the interventions, the surgeon has a better view of the hip joint. It allows the surgeon to work between the muscles and tendons without removing them from their anchoring points on the hip or thighbone. People undergoing traditional hip replacement surgery, for example, are advised not to bend at the hip more than 90 degrees for approximately six weeks after the procedure. I am Australian so no business from me but it has helped me become happier with my prospective surgeons judgement that he will offer me a posterior THR (hopefully the minimally invasive) when my insurance allows the procedure to occur. I am a 73 year old woman who has been having severe hip pain for the last seven months. Most individuals who have had total hip replacement surgery fall into this category and simply resume their lives.. Egton Medical Information Systems Limited. The most important decision you will make is choosing your surgeon. Typically, the new cup will be medialized to gain coverage and correct the abnormality that lead to your arthritis. The doctor has scheduled me for total hip replacement in two weeks and he uses the Posterior approach, he didnt say anything about the mini part. If I think you may be a candidate, I will refer you to a doctor in our area that does. I think it is important to define and isolate why youre doing so poorly. Comparison of short-term outcomes between SuperPATH approach and I emphasize continuing exercises at home especially walking. I then would strongly suggest you trust that person to decide what approach and what prosthesis predictably will deliver the best results. Notes on SuperPath experiences good or bad, https://patient.info/forums/discuss/superpath-experiences-good-or-bad-718788. I furniture surfed in the house and used a stick outside.I was hopeless with crutches, but I think it is recommended we should use them, particularly to ensure we don't get a limp and build our leg up properly. invasive posterior vs not so good with AMIS) whilst on the other hand, with one of your replies you state that surgeon experience should be considered with AMIS success rates and in other replies stating that both alternatives are good. Will meet with doctor soon but when I was finally able to really exercise after surgery I overdid it and developed plantar fasciitis. 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). An anterior capsule is the only soft tissue cut during this procedure to insert the implants. Surgeons do not cut across muscles. Is AL better than P for this? Hi, Yes, Im angry. 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. Finally, many people who are struggling with hip disease experience lower back pain or even sciatic discomfort. I had no inkling of this till he showed me on the x-ray. Most patients are able to walk the day of surgery. The SuperPATH technique is arguably the least invasive hip replacement technique. 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. Any info would be appreciated. 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. Posterior hip surgery may be the best option if your surgeon makes a larger incision at the side or back of the hip joint. 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 . Woke up with Uncemented. Contact Us, Approaches I would rather my patient get half as much anesthesia. Check to enable permanent hiding of message bar and refuse all cookies if you do not opt in. Testimonials I had to cut some strength exercises out leg lifts, hip sled. Hi Frances, did you have surgery posterior Superpath? I am just under 5 ft and weigh 185. Hard-on-hard bearings, such as ceramic-on-ceramic as well as metalon-metal articulations, also resulted in larger femoral heads being implanted. I just had mine 10/30 all I can say is be patient get lots of rest and take your pain meds way before you start to move around so that the pain want be so bad with movement. I am a 70 yr old female with a 4grade thickness loss at acetabulum and head of femur. Because these cookies are strictly necessary to deliver the website, refusing them will have impact how our site functions. Need to choose, then select doctor based on that decision. The anterior approach, as a marketing tool, has grown in popularity among surgeons. An anterior-approach hip replacement necessitates a small incision in the groin area on the front side of the leg. What are the experiences of other countries with THR? Other preoperative guidelines, such as using a prescribed pain medication and keeping the incision clean and dry, should also be followed by patients. The second most-common injury is to the femoral nerve. I have been told that I can fly 48 hours after surgery?? What is the best hip replacement option: anterior or Posterior? If they are really happy, then you probably will be as well. Possibly, its secondary to an altered gait pattern or hip mechanics. I wish you a full and satisfactory recovery. I prefer spinal anesthesia when possible because fewer drugs are used and often the experience is gentler. Even after the procedure is completed and the patient is on pain medications, pain and discomfort may occur in some cases. I wish your patient well. Thanks again for this great blog! Have you recovered by now? In the United States, a traditional posterior approach is the most commonly used. The SuperPath procedure was designed to replace the joint while sparing as much tissue as possible, substantially improving patients' recovery time. Some of the most common considerations are age, weight, activity level, and the presence of other health conditions. Why would the doctor not have that at their finger tips? Thank you. Your article lacks the pros of the AMIS and the cons of min invasive posterior. 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. Hip Preservation Surgery | Duke Health 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). 1. Thigh feels so Heavy and I massage that area a lot. A hip replacement is a common type of surgery where a damaged hip joint is replaced with an artificial one (known as an implant). Dont let PR marketing confuse the big picture. Better luck to you all. The anterior approach exploits an interval between muscles that cross the front of your hip and thigh. There is some concern that this weakens the abductor and leads to a limp. Also, only a small percent of C-on-C bearings are being implanted at this time. Our overall findings suggested that the short-term outcomes of THA through SuperPATH were superior to DAA. Also, I am diabetic and have had two organ transplants and am extremely worried about infections, etc. The same is true for a surgeon who employs the anterior or anterior technique. I would focus on the individual doctor, not the approach that the individual choses to use, to deliver the best result.