Potentially there also is less pain and a quicker recovery. Some people also tend to form scar tissue and contracture more readily than others. Gililand, our physician, explained the concept of health. THR if a MRI or Pet Scan isnt done? Traditional hip replacement surgery is no longer an option, but it is less painful and has a number of advantages. For example, the stability of the components could have been achieved initially, but then proved inadequate so you developed either a loose cup and/or a loose stem. A recent article published by the Journal of Bone and Joint Surgery has demonstrated that the direct anterior hip replacement has more blood loss, a higher risk of intraoperative fractures, an overall higher complication rate and no difference in outcomes versus other techniques. Ultimately, it is important to discuss all of the available options with your doctor to determine which method of hip replacement is best for you. If they are really happy, then you probably will be as well. I absolutely would not insist on minimally invasive surgery and a small incision, especially considering your mom is short, obese and has osteoporosis. What is most important is that the surgery is expertly done, that the tissues are not brutalized, and that the surgeon can see what he or she is doing. thank you for your time. I would say that in terms of posterior total hip replacement, the procedure is better than the old gold standard, which I believe was performed after 7 years and almost 1000 anterior total hips. I understand and respect that many surgeons prefer doing them simultaneously. The first surgeon never mentioned this condition at all. In 2010, more than 310,000 hip replacements were performed in the United States. All: This allows you to resume normal daily activities quickly while also returning to normal range of motion and function. The vast majority of my patients return to work one to three weeks post-operatively. No special surgical equipment is required when performing a mini posterior. 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. You are to be commended for taking the time to answer our questions. Because the patient is lying on his back during the procedure, fluoroscopy or moving x-rays are used to aid in the examination. Patient Concerns Ive done PT and plan to continue working on strengthening my core and flexibility of those large muscles. The nerve which supplies sensation to the front and side of the thigh is vulnerable. Many also mate this with a ceramic femoral head. Granted I do deal with lower back OA and right knee OA and now all worse and now foot/ankle mess, all on right hip side. 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. I am so sorry to learn that you are struggling. A shorter hospital stay and faster recovery are typical of this because there is less damage to the muscles. You helped me tremendously in my research of the track record of my HMO, now I have one more quick question to run by you. Patients understand the risks that metal joints and sockets bring to their long-term health and are moving away from the material. bible teaching churches near me. I would rather this not happen with my right leg when I have the THR in Jan 2017. Also available today are larger modular heads, made possible because our plastics are so much better than years prior. Surgeons do not cut across muscles. I know the most important decision you will make is choosing the doctor who will perform your surgery. Further, I would contact your insurance carrier and the hospital so you will not be surprised with any unexpected costs. It typically requires a 4 to 5 day hospital stay, 3 to 6 month recovery period . Also, the choice of femoral stem is more likely to be influenced by the approach and not the persons anatomy and hip mechanics. Get Directions, Phone: 954-489-4575 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. Some patients who have recently had anterior hip replacement may suffer from complications such as wound healing. J. Dear Dr. Leone, I wish you the very best, How long will my hip replacement last? The most important decision you will make is choosing your surgeon. It is nice to see honest Q&A versus a marketing page. Read our editorial policy. I have/had arthritis in my hips. I have not seen this before because in the past, the complication from hip surgery were sciatic nerve injury from posterior approach. Most patients after a bilateral procedure would not go home but rather a rehab unit. Our second opinion doctor performs traditional and Birmingham hip replacement. This improved quality of life will be beneficial. Also, be aware that as the nerve recovers, the smallest C fibers within the nerve recover first, which can cause a burning discomfort. I had no inkling of this till he showed me on the x-ray. We want the forums to be a useful resource for our users but it is important to remember that the forums are It is much better to precisely release and cut rather than tear or fracture. It helps the surgeon implant the acetabular component in a very precise position. That being said, you should have the additional surgery where you feel you will have the best chance of doing well. I spoke to the surgeon, he believes it may take up to 6 months to get better from this neuropraxia. The information I have gathered seems to indicate the anterior approach is more inherently stable, making precautions unnecessary. If your surgeon has recommended surgery, I assume youre no longer getting adequate relief of pain or able to remain active with conservative measures. 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. Infection: You are given IV antibiotics before and after surgery. One disadvantage to the mini posterior approach is that patients are instructed not to place the newly implanted leg in certain positions for the first six weeks after surgery. It seems that whatever their particular approach is that is what they sell. A ceramic-on-ceramic bearing is also a very good bearing. It is important that you find a doctor who is experienced in caring for people with complex issues. My surgeon uses the posterior approach. 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. If you have an abnormal anatomy or are morbidly obese, you may not be a good candidate. According to Dr. Gililand, patients should not try to change their surgeons opinion based on their preferences. I had my hip scoped which bought me 8 years, but need a THR now. I have a good surgeon (same one as last time) but I dont know how he would feel about my asking if a mini posterior (or posterior) procedure be carried out, so as to preserve as much strength in my right leg as I now have.Do as many muscles need to be cut in the mini posterior procedure? The SUPERPATHTM procedure provides a number of advantages over traditional hip replacement surgery. If this occurs, the patient usually requires a total hip replacement. The majority of teaching institutions in the United States continue to instruct as well as perform the traditional posterior as their primary approach. What do you consider to be the most important factors in choosing a surgeon? Thank you for sharing with others the nerve supplements that youre finding affective. These parts have a porous coating that the bone grows into. Dr. William Leone. 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. (tho I am sure I asked about it ahead of time), I believe you are having trouble finding definitive answers and recommendations because every surgeon has his or her own recipe and experience and also the medical recommendations keep changing. I'm hoping to read some posts post surgery. In my experience the approach used to replace a hip does not effect how quickly a patient recovers. Following the anterior approach, we provide you with a number of precautions and positions that you should avoid if you are in danger of being discomfited. I would avoid the metal-on-metal articulation. If I think you may be a candidate, I will refer you to a doctor in our area that does. 2023 Brandon Orthopedics | All Right Reserved, hip replacement pain reduction surgery patients, The Best Sneakers For Hip Replacement Patients, Anterior Hip Replacement Surgery: The Pros And Cons, The Truth About Spinal Stenosis: Causes Symptoms And Treatments, Can Years Of Surfing Contribute To Spinal Stenosis, The Effects Of Spinal Stenosis And Carpal Tunnel, Should I Apply Ice Or Heat To A Compression Fracture, How Does A Soft Bed Prevent Healing Of Herniated Disc, Herniated Discs: How To Sleep Without Worrying About Rupturing Your Discs, If You Have A Herniated Disc You Know The Excruciating Pain It Can Cause. What determines the differences? Share your concerns with your surgeon. Welcome to Brandon Orthopedics! 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. 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/[email protected], The Pros and Cons of Two Approaches to Hip Replacement: Mini-Posterior and Direct Anterior, Copyright 2018 - 2023 The Leone Center for Orthopedic Care. The surgical "approach" in total hip replacement describes the anatomical pathway and technique that the surgeon uses to access the hip joint to perform the surgery. The same is true for a surgeon who employs the anterior or anterior technique. I am temped to wait but it is getting worse. Dear DR Leone, If possible, choose a hospital that specializes in joint replacement and can back that up with excellent statistics and reputation. Every prosthetic joint has a mechanical range of motion. I am so sorry to learn that you have had such a bad experience after THR. Celle said: Superpath may give you a faster early recovery, but whatever method is used, recovery is still going to take a long time. Dr. Robert Sigmund is a board-certified orthopedic surgeon and a sports medicine physician based in St. Louis, Missouri. Having diabetes and two organ transplants does significantly increase your risk for post-op infection as well as other complications. I am deciding that my quality of life is in the toilet and need to get the THR done. Over time, some patients may acquire sensitivity or an allergy to the metal particles produced by the metal ball and socket. I have been less active this past year and am concerned that losing weight prior to surgery might be an issue, Am also wondering about my auto immune issues and the implant. The anterior approach, as opposed to the lateral or posterior approach, uses a small incision in the front of the hip. There are a few disadvantages to hip replacement surgery. Thank you for sharing. Because the gluteus medius and minimus lie over the anterior capsule and insert into the greater trochanter, it does require greater trochanter osteotomy or more commonly a partial elevation of these muscles from their insertion, which can lead to damage. No i just had the posterior method which has a larger incision. If you would like a personal consultation, please contact our office at 954-489-4584 or by email at [email protected]. Any feedback will be appreciated. It is critical to make the right decision regarding anterior hip replacement surgery in each case. In my last blog post, I discussed minimally invasive surgery with regard to hip replacement. I have read your articles about procedures (anterior vs posterior). I think there may be increased associated complications. SuperPath approach uses about a 3-inch incision at the side of . This is actually a good sign. In the United States, a traditional posterior approach is the most commonly used. I wish you a full and satisfactory recovery. 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. In bed for long periods with little or no movement. 2015 Aug. 3 (13):179. He treats a variety of hip, knee, and shoulder conditions, and performs hip and knee total joint replacements. Obese or extremely muscular people may not be the best candidates for this surgical procedure. With mild dysplasia, positioning and implanting the new cup usually is not more difficult than with other conditions. It was also observed to be associated with longer surgery times. 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. Thank-you. Dr. William Leone. An anterior capsule is the only soft tissue cut during this procedure to insert the implants. Avascular Necrosis AVN of the femoral head happens when part of the ball at the top of your thigh bone loses blood supply, causing that segment of bone to die. The femoral prosthesis is inserted into the hollow part of the femoral shaft. Can I expect any problems with the bilateral it was my choice. Some surgeons will use 2 incisions, both the anterior and superior approach. And does A really have none. 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. crackling noise/pain, cannot bend them or kneel in church or get on the floor to do exercises, I am very afraid to ending up in a wheelchair or having to use a walker the rest of my life.I am a very active 65 year old, and very, very worried about the hip surgery. It exploits the inter-muscular interval between the tensor fascia lata and the gluteus medius. I feel that at 10 weeks with profuse denervation potentials on the quad muscles, the prognosis is not good, even at 6 months. But I feel that time could be lost and all my symptoms may become irreversible. OTC nerve supplements suggested by a naturopath. Fort Lauderdale, FL 33334 He also used the term anterolateral. My surgeon mentioned also cutting something to free me up at the same time he will be doing the posterior approach surgery. The doc I saw yesterday said 4 weeks. Use of the forums is subject to our Terms of Use Dear Dr. Leone: I dont think one surgical approach is better or worse than the other for you to accomplish this. Please comment. Contact Us, Approaches Does my prothesis not last as long since I am now doing a 3rd surgery? I would encourage you to discuss your expected recuperation time and specific restrictions with your surgeon. When the stem is placed in the femur, it still destroys the same amount of bone for implantation, regardless of which approach is used. 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 . 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. I live in the UK so again Im afraid I wont be able to consult you personally! No Muscles Cut is for billboards. 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. There is some concern that this weakens the abductor and leads to a limp. It's a hip replacement surgery where you lie on your side. I understand they have good results in Thailand or India for half that. Doc, Ive worked out and been physically active forever running, biking, skating, etc. I did have a total knee replaced two years ago. I think cutting muscle was in the past.

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