out the next afternoon and using a walking stick from day 2 to day 10 when I ditched it altogether . Many wonderful physicians are part of various HMO panels. How long will my hip replacement last? A ball and socket are used to connect the new joint to the thigh bone (femoral bone), which is made of metal, plastic, and ceramic. I believe a THR will benefit you tremendously. Welcome to Brandon Orthopedics! It will help desensitize and help get your muscles working in synchrony. Most patients after a bilateral procedure would not go home but rather a rehab unit. Does this mean my body may reject the metal of the post or cup? What is the best stem and ball/socket combo to use for someone that ones to play tennis? The vast majority of my patients have their surgeries with a simple spinal with IV sedation so they are sleeping throughout the procedure . 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. This often leads to a less than optimal component position. Specific protocols, therapy and what positions you will be asked to avoid after surgery and for how long will be directed by your surgeon. My walking is very limited, shoe is built up as leg is shorter and in recent months Ive realized my leg is bowed. It seems reasonable and I trust my surgeon but would like to know what I'm in for post op and beyond. The risk of revision surgery after a posterior hip replacement is the most serious concern. I still maintain that by far the most important decision patients must make is choosing the surgeon who will do their surgery and take care of them, then trusting that individual to choose the approach, prosthesis and make a million other decisions that deliver as perfect a result as possible. We have an appointment today to discuss the plan of action. posterior 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? Both have valid cons against the others methods and pros on their method. Can you explain it to me as he didnt go into detail. Gililand, our physician, explained the concept of health. Anterior hip replacement has the potential to cause complications and pose some risks. It is also important to avoid any sudden movements or twisting motions. A orthopedic surgeon may insert a numbing agent directly into a new joint, which can last up to 48 hours. 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. Even after the procedure is completed and the patient is on pain medications, pain and discomfort may occur in some cases. I have been in pain for about a year and first though it was a back issue and it has limited my ability to stay as active as I would like. 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 . Im a very healthy long distance bicycle rider. 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 am 63 years old, 54, 115 pounds. This effectively moves the hip joint center, toward the bladder or midline, and improves hip mechanics. Its been 9 months(Ive had it 2xs bf and got rid of it and have tried everything and no results this time). Thanks! (Of course, I do.) Being discharged to a rehab unit is now the exception. Choose your surgeon and not the approach or prosthesis. Tina, which procedure did you have? I again suggest you concentrate on finding a surgeon in whom you have faith and then trust that doctor. With the ease of movements during pregnancy, you will be able to move around more freely. 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. Each surgeon approaches these issues individually. Click to enable/disable Google Analytics tracking. There are a number of different potential surgical approaches available for hip replacement, each with their own potential advantages and potential drawbacks. In 2010, more than 310,000 hip replacements were performed in the United States. Thank you for sharing. Consult your doctor to determine if joint replacement surgery is right for you. They thought surgery to repair it would give me about 5 yrs. They may have a certain cut-off criteria (for example, a BMI of less than 35). Hard-on-hard bearings, such as ceramic-on-ceramic as well as metalon-metal articulations, also resulted in larger femoral heads being implanted. I am a 55 year old with a labral tear and moderate arthritis. In another day I was able to take short walks without any limping, etc.. Dr. William Leone. From what Ive seen, most THR patients dont need very much PT, although I do encourage exercising in a pool. He also used the term anterolateral. My doctor does the Posterior approach, he didnt say anything about the mini part. The particular surgeon who did your hip is also uniquely qualified to advise you with regard to the postoperative stability of your particular hip, because he or she physically tested your hip intra-operatively. I am 56 now and find that physical therapy and chiropractic care dont seem to be helping anymore. Ten years ago I had total hip replacement on the left at hss. I saw a surgeon who does the posterior approach only and will see another on 4/14/15 who does both approaches. Every surgery should be done with as minimally invasive approach as possible taking into account these other critical factors. Why is that? Many also mate this with a ceramic femoral head. How do you ask your doctor the questions you want to ask? 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. Because of the concerns of posterior dislocation, in the past patients were taught certain positions to avoid. We can do this because of improved plastics. Even if the hip doesnt dislocate, prosthetic or soft tissue impingement is not beneficial. Click on the different category headings to find out more. One of the potential disadvantages is that because the surgery is performed through the front of the hip, there is a risk of damaging the hip joint and the surrounding muscles and tendons. Also I have read that there is a sharp learning curve that must take place in order to do the direct anterior approach. Will I still be able to do the things I like to do? The most important thing is that tissue is handled gently and trauma is minimized, whichever approach is used. 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. I would not anticipate them improving with time, but rather worsening, and I cant imagine you being able to resume the activities you described without having surgery to treat this. Others will be empowered when they read and relate to you and/or your experience. An anterior approach hip replacement is one of the most minimally invasive surgical options for replacing a hip. Problem is that we have seen two doctors and both seem great but are on two extreme sides of the fence. I play in the 50s age group. Would not make eye contact. My legs are very muscular and trim. Thank you, Rita. Very sorry to hear of the difficulties you experienced! According to Dr. Gililand, patients should not try to change their surgeons opinion based on their preferences. It allows the surgeon to work between the muscles and tendons without removing them from their anchoring points on the hip or thighbone. Considering I had no idea about differences between the two approaches, I said OK and surgery did go well and I was back on my feet in no time. Of note, I am a RN with 30 years of experience and took this decision very seriously. Can you please on the various points in the post and perhaps also elaborate on the last point. I would discuss fully your goals and concerns. 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. That being said, if the foot is now a much bigger problem than the hip, you may have to deal with that first. Or are x-rays definitive for determining the exact reason for THR? Many patients approach this by researching online and speaking to other patients who have been cared for at a particular facility. 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. The surgical technique for a SUPERPATH Hip Replacement was developed as an advancement to traditional total hip replacement. The anterior approach typically does not violate this structure. Everything does point to posterior being the better of the two, but first i wasnt given a choice, and much easier said to shop for surgeon, than to do it, when only one in this area takes my insurance. Posterior or Anterior? This risk is greatest in older females with bone of sub-optimal quality. Mine certainly have. I have linked back to several blog posts below that will give you more in-depth information. Do you agree? 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. It sounds as if you had a wonderful surgeon. You are here: Home 1 / avia_transparency_logo 2 / News 3 / disadvantages of superpath hip replacement disadvantages of superpath hip replacementtesla floor mats, model y June 7, 2022 / kimt contest page / in are dogs allowed at schoetz park / by / kimt contest page / in are dogs allowed at schoetz park / by Some of the most common considerations are age, weight, activity level, and the presence of other health conditions. The idea is it should be a little less painful if the muscle, tendons and nerves are not disturbed. How long will my hip replacement last in your opinion? A ceramic-on-ceramic bearing is also a very good bearing. Lastly, if one has had P or AL is there anything that can be done to offset the need for restricitons? No i just had the posterior method which has a larger incision. Last summer I wiped out on my bike and snapped off the top of my right femur, with a diagonal break. Traditional hip replacement surgery is no longer an option, but it is less painful and has a number of advantages. 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. Since my acetabulum is too shallow, and other angles are off as well, how does the new cup get positioned correctly? I am allergic to narcotics . I suspect that your surgeon has continued to refine his or her technique based on experience over the past five years, in the same way I have. Sometimes, it simply isnt possible to accomplish. There are many effective approaches and techniques that allow implantation of a total hip. In general, if someone is dedicated to the job, the return is very quick. I think the recovery time is the same though. Note that blocking some types of cookies may impact your experience on our websites and the services we are able to offer. 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. Our insurance covers both. Its been six months since surgery, my operating doctor keeps feeding me with lets wait another month stuff. They also are looking into methods to reduce the risk of infections in artificial joints. There is less blood loss with a single THR than a bilateral, hence less risk of needing a transfusion. Dear Dr. Leone, Finally, I would choose a doctor with whom you connect and whose staff is engaged and knowledgeable. In my practice, patients who undergo a THR using a mini posterior or posterior approach: 1. 35 (2):153-62. Also, in the U.S., nearly all stems which are being implanted through the anterior approach are press-fit rather than cemented. 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. Thank you. Also on MRI there was a cyst (good size). But I am now in chronic low grade pain thats getting worse and dont know what I should do. 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 would recommend having an honest discussion with the surgeons you are considering. These scores are not aggregated. Yes, you do have increase risks. Though the duration of your hospital stay can vary, many patients having hip replacement surgery don't need to stay in the hospital very long. Fortunately you live in a part of the world where there are many capable orthopedic surgeons. Read our editorial policy. It is important that you find a doctor who is experienced in caring for people with complex issues. I would not recommend pushing your surgeon to use one specific approach or another. 2004 Apr. My surgeon mentioned also cutting something to free me up at the same time he will be doing the posterior approach surgery. The actual length of the incision really is not important, but rather how well the components were implanted and the hip mechanics restored. It is difficult to get that from information which I find curious. Other jobs, which tend to be more structured and / or more physical, may require more time off. I am a sixty five year old active male and need THR on my right hip. I am feeling like this is a business like everything is else. Glad that after lots of PT and massage and medial branch block for back issues with NO!!! Adult patients who have a deteriorated hip may be candidates for total hip replacement. Contact Us, Approaches Patients mobilize the day of surgery and typically go home the next day. Dear Dr. Leone: You can do anything you want after a hip replacement. I have seen 2 doctors one doing posterior, the other anterior. I went in with high expectations of coming out so much better off and here I am 5 yrs out limping more than ever and a NUMB thigh and worse knee and weak ankle. This technique avoids cutting muscles and tendons, minimizing surgical trauma and improving the post-operative experience. One thing I do not want is any muscles or tendons cut in the procedure. When people loose independence and mobility, not only does the quality of life suffer, they are much more likely to develop a myriad of medical problems requiring even more-expensive and/or long-term care, including loss of independent living. Over the last decade total hip replacements have been performed using 2 main approaches: The posterior approach in which the hip joint is approached from the back by releasing and reflecting the short external rotators and dividing the capsule at the back of the hip; and the anterolateral . There is no definitive answer to this question as different people will have different opinions and preferences. I had an anterior right hip replacement in late 2010, I was 72. Ill be 60 at the time and Im 54 and weight about 130 lbs in fairly good shape. Because these cookies are strictly necessary to deliver the website, refusing them will have impact how our site functions. I understand that most surgeons now do a spinal rather than general anesthesia. If your surgeon did a great job, that is something to respect. My surgeon does the SuperPath method. Thigh feels so Heavy and I massage that area a lot. Infection: You are given IV antibiotics before and after surgery. Thank you for all you do and for providing me with the information when I needed it. Thanks again! You are to be commended for taking the time to answer our questions. I live in the UK so again Im afraid I wont be able to consult you personally! My husband tells me that I cry out in pai as I turn over during the night. Intervals between muscles are separated or muscles are separated in line with their fibers without injuring the muscles innervation. 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.