I try not to let it get to me, but it causing me to feel handicapped. Thanks again for this great blog! 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. These cookies collect information that is used either in aggregate form to help us understand how our website is being used or how effective our marketing campaigns are, or to help us customize our website and application for you in order to enhance your experience. It requires surgical insight and skill to accomplish. Historically short press fit stems have not done well. Will I still be able to do the things I like to do? United States. Optimal component positioning also is critically important for the best stability and longevity. Most individuals who have had total hip replacement surgery fall into this category and simply resume their lives.. 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. Many, many interactions and decisions go into the final result as well as someones perception of his or her result and experience. The rest is marketing. Hip Resurfacing vs Total Hip Replacement - sosbones.com Im hoping to play tennis, go dancing and horseback riding once Ive healed. As a result of the interventions, the surgeon has a better view of the hip joint. What Is Superpath Hip Replacement - HipsAdvice.com Disadvantages of the anterior approach include: The nerve which supplies sensation to the front and side of the thigh is vulnerable. I have never operated on another surgeon who asked me to make as small an incision as possible or use the minimally invasive approach. It also helps to stabilize the acetabular shell and prevent soft tissue irritation on the out edge of the cup. I, personally, have not had a patient dislocate following a primary total hip replacement in many years. Im hearing no restrictions (once recovery is done) for Anterior, but always some for the other two. You are to be commended for taking the time to answer our questions. SuperPath hip approach. The pain I get is in the groin and a sharp pain in the buttocks, that feels like muscle pain. Six weeks or longer is the exception. The SuperPath procedure was designed to replace the joint while sparing as much tissue as possible, substantially improving patients' recovery time. Once the surrounding tissues fully heal, they then act as a mechanical block to the ball to keep it from being able to jump out.. A hip replacement can greatly reduce the pain associated with arthritis of the hip, with almost all patients having complete or near-complete relief. The healing and maturation of this tissue takes time. For many years, I performed bilateral THR and bilateral TKR procedures, but have backed away for a variety of reasons. The posterior approach for hip replacement surgery is by far the most common surgical technique used in the United States and throughout the world. I think it was sensible being careful on the other hand and I was told not to cross my legs. If I have a 2nd revision of my right hip is it posterior approach or the mini-posterior approach as you discuss above? I think the recovery time is the same though. The first is that it is a major surgery, so there is a risk of complications such as infection. Celle said: Superpath may give you a faster early recovery, but whatever method is used, recovery is still going to take a long time. Problems such as osteoarthritis, rheumatoid arthritis and avascular necrosis can destroy the protective cartilage around the hip joint, disrupting the smooth contact between the femoral head (ball) and hip socket. Hi, A major hip replacement can take up to four months to fully recover from. Egton Medical Information Systems Limited. I wish you the best of luck. 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. Surgery carries increased risks because of these conditions, but by defining the risks and optimizing any underlying conditions, the risks can be minimized and hopefully managed. When the stem is placed in the femur, it still destroys the same amount of bone for implantation, regardless of which approach is used. Consult your doctor to determine if joint replacement surgery is right for you. Pros and Cons of Robotic Assisted Surgery - Carrothers Orthopaedics Do I have a risk of fractures during a posterior right hip revision due to my prior complications already? 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. This can cause you persistent pain, stiffness . The art of surgery should mimic a well rehearsed ballet or symphony. The SUPERPATHTM procedure provides a number of advantages over traditional hip replacement surgery. 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. Are my findings that posterior approach in my situation would have been more appropriate? As you can see, there are no restrictions. Some people may find that traditional hip replacement surgery is the best option for them, while others may prefer a minimally invasive procedure. While new techniques, instruments and prostheses have been developed specifically for minimally invasive surgeries, there are many well-established approaches to hip replacement. The most important decision you must make is choosing your surgeon. This is because the nerve is located in front of the hip. I also would encourage pool walking or swimming. I am 37 and have suffered from AVN since I was 14. Often, as the labrum is torn, it leads to a lifting off of hyaline articular cartilage where these two tissues meet, called delamination. Hip replacements might keep you out of action for a considerable period. I also think its reasonable to look forward to returning to all of the listed activities that you enjoy. There are potential drawbacks to anterior hip replacement. Evidence review for hip replacement approach - NCBI Bookshelf Further, the extent of dissection is more minimally invasive, which also improves stability. Dr. William Leone, Hello Dr. I also think infection must be investigated and ruled out. I was out of bed walking around the evening of the surgery . Consuming excessive-fibre and wholegrain meals will assist to keep you feeling full, and will be disadvantages of superpath hip replacement The anterior approach exploits an interval between muscles that cross the front of your hip and thigh. Good question. Hip Replacement Surgery | Superpath Hip Replacement Sydney Australia Because the patient is lying on his back, it facilitates using a fluoroscope or moving x-ray throughout the procedure. Complications from infection account for approximately 10% of all cases. I feel that at 10 weeks with profuse denervation potentials on the quad muscles, the prognosis is not good, even at 6 months. The surgery is more difficult and more exacting . The initial recovery period typically takes six weeks or more. My advice is to consult with your surgeon regarding how stable the replaced hip is and the most appropriate rehab to follow post-operatively. About how much does this cost? Dear Dr. Leone, I am having Makoplasty ( robotic imaging) to my right hip in February. The Pros and Cons of Two Approaches to Hip Replacement: Mini-Posterior Your primary goal should be to find a surgeon in whom you trust and who will take the workmans compensation insurance. I again suggest you concentrate on finding a surgeon in whom you have faith and then trust that doctor. 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. Most patients are able to walk the day of surgery. 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. This then becomes a very difficult problem to solve. The incision made for the operation can be as small as three inches. Hello Dr Leone, 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. Im ready to have the surgery, having been basically bone on bone for several years. The bone isn't dislocated in surgery. Comments about life-long hip restrictions between Posterior, Anteriorlateral and Anterior approaches? Also, patients with shorter femur necks and genu varus (lower angle between the shaft of the femur and the femoral neck) are more difficult anteriorly. 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. I have done everything I can think of to preserve my right hip, but sadly this too needs replacing. The new prosthetic socket must be medialized (placed further toward the midline) and sometimes through the medial wall of the native socket. I am a competitive tennis player in my age division. Patients who work for themselves are very motivated to return to work and often do so between procedures. I wish you the very best, If not, what will my restrictions be? Surgical Approaches Used for Hip Replacement - Verywell Health Dr. Leone, I am coming in to see you for an appointment for a THR to my left hip. disadvantages of superpath hip replacement. We now have too many other proven bearing surfaces available. If you feel confident in your surgeon, I would discuss it frankly follow his or her guidance as to which approach and prosthesis are most appropriate to give you the best result. By continuing to browse the site, you are agreeing to our use of cookies. The socket of the pelvis is machined into a hemisphere and a metal hemisphere is inserted into the socket. I wish you a full recovery. How long will my hip replacement last in your opinion? The surgical area of anterior hip replacement is located in the vicinity of the lateral cutaneous femoral nerve. Pam. Because of this, when you're ready to get up and walk about again, engaging your muscles and hip flexors might be extremely tough. I wish you a full and uneventful recovery. disadvantages of superpath hip replacement - homelessnest.org I very rarely transfuse any patients now. What Ive been able to achieve is find two nerve supplements that have taken away the burn/tingle on my thigh. I will need the other hip done within the next 6 months, and despite all the talk of the anterior approach- I can use myself as the best judge to the best method. 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. The anterior approach has a lower incidence of sciatic nerve injury and a higher incidence of femoral nerve injury. Im not sure why you developed a problem with your IT band. Hip replacement - Mayo Clinic Introduction Unfortunately, short of conservative and supportive measures, only time will tell. Comparison of short-term outcomes between SuperPATH approach and I would suggest seeking out doctors who specialize in hip replacement surgery rather than general orthopedics. Im a very healthy long distance bicycle rider. 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. It helps the surgeon implant the acetabular component in a very precise position. He strongly recommends the anterior approach as the only way to go. 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. Thanks! 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. Posterior, mini posterior or anterior? I think cutting muscle was in the past. Further, I would contact your insurance carrier and the hospital so you will not be surprised with any unexpected costs. Studying a hospital and physicians track record before you commit is important. Raleighs orthopaedic clinic is board certified and has fellowship training in total joint replacement. 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. As a result of this precaution, it is difficult to sit on low chairs, sofas, or toilets. This site uses cookies. Every surgery should be done with as minimally invasive approach as possible taking into account these other critical factors. Because of the restricted view provided by the anterior incision, the anterior incision is a technically demanding procedure. The Hanna bed, general anesthesia machines, spinal setup, medications, ventilation, instruments, and their sterilization are all prerequisite. My surgeon does the SuperPath method. SuperPATH hip replacement Pros and Cons - Thoracentesis SuperPath Hip Replacement? | Joint Replacement Patient Forum Notes on SuperPath experiences good or bad, https://patient.info/forums/discuss/superpath-experiences-good-or-bad-718788. We now have less-invasive techniques, better surgical methods of closing soft the tissue and more experience. Hip replacement - Wikipedia I already have an artificial knee that is doing great. I am a 70 yr old female with a 4grade thickness loss at acetabulum and head of femur. Due to security reasons we are not able to show or modify cookies from other domains. My advice is to focus on finding a surgeon with whom you are comfortable and have the best chance of doing well. There is significantly less bleeding with the mini-posterior approach, notably reducing the necessity of a blood transfusion after the surgery. There is a chance of nerve injury with any type of hip replacement. With the ease of movements during pregnancy, you will be able to move around more freely. Sometimes, when a surgeon is working too hard to reconstruct through a very small incision, the ends of the incision tear and the tissues are traumatized. Femor fracture. Your article has made it clear I made the correct decision, especially since my daughter had nerve damage from an operation years ago. I have been in excruiting pain and unable to do everyday normal activities. What, if anything, can be done to revive femoral nerve and get my thigh muscles back in normal? Posterior hip surgery may be the best option if your surgeon makes a larger incision at the side or back of the hip joint. The posterior approach is used by a small percentage of people. Infection: You are given IV antibiotics before and 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. I think its vitally important that you go into surgery truly believing in your heart that you are going to do well, and that you are with the best surgeon and team who will help you. The SuperPATH technique is arguably the least invasive hip replacement technique. The physical build of some patients increases the difficulty. Changes will take effect once you reload the page. 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. 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. I just want to thank you for the information on this site. A ceramic-on-ceramic bearing is also a very good bearing. Hard-on-hard bearings, such as ceramic-on-ceramic as well as metalon-metal articulations, also resulted in larger femoral heads being implanted. Many believe that this results in less risk of infection. A mini posterior approach is a modification of the classical posterior approach. Procedures Ken. That being said, you should have the additional surgery where you feel you will have the best chance of doing well. I would encourage you to discuss with your surgeon the difficulties and pain you experienced after the first surgery, and together explore if another plan can be created for a better outcome the second time around. There are various ways of doing a hip replacement. The amount of PT you need after surgery will be determined by you and your surgeon. The surgeon will be building a construct that hopefully will last her life time and change her life profoundly. I wish you the best of luck, Sex After a Hip Replacement: Positions, Tips, and More - Healthline I would encourage you to discuss your concerns with you surgeon. Length of hospital stay with SuperPath hip replacement approach. Common conditions that often lead people to have either posterior or anterior hip replacement surgery include the following: Osteoarthritis Rheumatoid Arthritis Osteonecrosis, also known as Avascular Necrosis Injury Fracture Bone Tumors Surgical Techniques THOUGHTS? It seems, however, that at this time point, patients who have received resurfacings do as well or better than similar patients who have received total hip replacements. superpath total hip replacement animation - YouTube Very strange Anterior hip replacement has the potential to cause complications and pose some risks. Have you heard of something like this, and if so, is it worth it? Unfortunately, injury to the lateral femoral cutaneous nerve is a common complication after the anterior approach for hip replacement. These stems are a new design, and therefore do not have an established track record. Mayo Clinic researchers have studied ways to reduce blood loss, control pain and speed recovery for people who undergo hip replacement surgery. I had an anterior right hip replacement in late 2010, I was 72. My two questions are: 1. It is difficult to get that from information which I find curious. Surgical approach is important but its just one of many important variables. This does expose the patient to more radiation but can help with component positioning and sizing. I exhausted all other non-surgical options, such as physical therapy and meds but to no avail, so now plan to have a THR in March. Dr. William Leone. This most often leaves the patient with an area of decreased or uncomfortable sensation or numbness over the anterolateral thigh (top, outside area of the thigh), not the entire thigh. DePuy Hip Replacement - Overview of Complications, Lawsuits I emphasize continuing exercises at home especially walking. You should consult with your doctor before deciding to have an anterior total hip replacement. Such joint replacement orthopaedic surgery is generally conducted to relieve arthritis pain or in some hip fractures.A total hip replacement (total hip arthroplasty or THA . out the next afternoon and using a walking stick from day 2 to day 10 when I ditched it altogether . It is critical that the patient and the doctor consider whether the patient is a good candidate for surgery, the cost and recovery time, and the surgeons expertise. Use of the forums is subject to our Terms of Use It is 100 percent normal and expected to be scared before surgery. Ten years ago I had total hip replacement on the left at hss. I have had problems with my hip for the last several yrs. In my 25 years of practice, the variable that seems to have changed the most is how quickly people recover from this surgery when done well. There are many factors that contribute to whether or not someone is a good candidate for anterior hip replacement surgery. Comparing Short-term Outcomes After Direct Anterior and SuperPATH Hip My recommendation is for you to discuss this with your surgeon if you have further concerns. I assume PTHR is referring to partial hip replacement. I think the recovery time is the same though. Are these expectations realistic? The first surgeon never mentioned this condition at all. A number of patients who have undergone this procedure are able to walk unassisted the day after surgery . Seeing that a THR is considered major surgery, my question is, should I have my left hip done sooner than later to address the length difference or wait until I can no longer tolerate the pain? 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. 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! Traditional hip replacement surgery is no longer an option, but it is less painful and has a number of advantages. Each approach has advantages and disadvantages. If youre impressed by how clean it appears and the movement and professionalism of the staff, that obviously is a good sign. Complications My main concern is that I have a tilted sacrum and a very sway back. Some patients who have recently had anterior hip replacement may suffer from complications such as wound healing. 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. How do you ask your doctor the questions you want to ask? Hips that are out of joint have an anterior hip replacement. Hospitsl staff Does anyone ever attempt to do both at the same time if THR is determined? Hip Replacement Surgery & Recovery | University of Utah Health A hip replacement is an excellent option for people who suffer from significant pain and disability as a result of arthritis in the hip joint. According to Dr. Rosen, the most important thing to remember is what you leave behind rather than how you get there. SuperPath hip replacement is a newer method and has been used since 2019 at Leicester's Hospitals. I am seriously looking at the infection rate at each facility. Is a prerequisite for THR to have a MRI or Pet Scan? Even though I was positive I wanted this method done, I was still questioning my decision. 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! Personally I had the posterior approach and cannot see how I could have recovered any faster . Third, the procedure is shorter in length and requires less hospital stay than traditional hip replacement surgery. I then would trust your doctor to select the prosthetic that would deliver the best result according to your goals and allow you to return to activities that you enjoy. My second question relates to something you mentioned earlier regarding checking the published track record of the surgical team if I use an HMO, how do I find that information, and how do I know it hasnt been skewed to give more favorable results (lying with statistics)? I spoke to the surgeon, he believes it may take up to 6 months to get better from this neuropraxia. SuperPATH showed better results in decreasing operation time, incision length, intraoperative blood loss, and early pain intensity. Clearly, yours was. Nobody wanted to talk With that said, I would have probably just done the posterior with you if we lived in the US based exclusively on the time you take to respond! Surgical Approaches To Hip Joint Dr. Apoorv Jain D'Ortho, DNB Ortho . Infection. An artificial joint is used to replace the worn out hip joint during a hip replacement procedure known as posterior hip replacement. That being said, in order to meet your goals, if need to leave your area and consult with surgeons in other areas, I think that is reasonable also. Please do not take this as an attack, but your article seems biased on your experience (great results with min. Because visualizing the femur is easier, an experienced surgeon can choose the most appropriate femoral implant rather than just the one that is easiest to implant, taking into account the patients bone quality, activity level and age. I really appreciate this website. Your article lacks the pros of the AMIS and the cons of min invasive posterior. Clots can form in the leg veins after surgery. A metal or plastic implant is used to replace a damaged or diseased hipbone. With much respect I look forward to your reply. Many manufacturers are responding to the surgeons desire for shorter stems and many are now available on the market. I just saw a patient with a femoral neuropraxia after a anterior approach THR. Thanks for any feedback. All have advantages and disadvantages. I was told to wait 6 weeks before I resumed my exercise regiment. Can You Go Home the Same Day After Hip Replacement? There are a few disadvantages of anterior hip replacement that patients should be aware of before undergoing the surgery. More soft tissue trauma can result do to this increased difficulty in exposure and then gaining more exposure if necessary. What is your experience and take on this ? I am deciding that my quality of life is in the toilet and need to get the THR done. I love that you take time off to reply to these messages it is commendable.