I am a 67 year old woman who has danced semi-professionally and has always been very active including doing Ashtanga yoga and caopeira. 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! General comments will be answered in as timely a manner as possible. 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. For the prevention, diagnosis, and treatment of hip pain and other problems affecting your hips, call Advanced Sports Medicine Center today at (941) 957-1500. Felt very uninformed and left 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. My walking is very limited, shoe is built up as leg is shorter and in recent months Ive realized my leg is bowed. A less stringent set of precautions is required with the anterior approach. Lastly, if one has had P or AL is there anything that can be done to offset the need for restricitons? It can lead to numbness in the thigh and, in rare cases, skin irritation due to the nerves presence. Its interesting that when we critically analyze all the variables that ultimately make up the experience that one person has compared with another, or that one person experiences on one side versus the other, we come to recognize its not so straightforward. If was 3 weeks after discharge Also there are concerns about disruption of blood supply to femoral head with this operation. Have you heard of something like this, and if so, is it worth it? Sex After a Hip Replacement: Positions, Tips, and More - Healthline Also had This surgical procedure is performed with a patient lying on their side, and a surgical incision made along the outside of the hip. 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. Changes will take effect once you reload the page. We now have too many other proven bearing surfaces available. Ultimately, you and your surgeon should discuss all procedures and technologies available and then trust that your surgeon will choose the best course of treatment and surgical procedure for you. Dear Dr. Leone, 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. I am 37 and have suffered from AVN since I was 14. Once again, I think your decision to proceed with THR is the most reasonable. Like you said, consistent outcome is important and this surgeon is excellent and I have great faith in him (Im a physical therapist and see his patients post-op so get to see the, at least short term, results myself). In a posterior hip replacement, the procedure is done on the side of the hip. I am a 55 year old with a labral tear and moderate arthritis. Thank you. Many people seek anterior hip replacement due to the unbearable pain they feel in their hip joints. Dear Dr. Leone, Thank you, Lisa. How the soft tissues are handled and respected, the patients expectations before the surgery and the surgeons experience do. It's cut off and removed through the hole. Thank you for this information. Gary. The experiences will vary greatly . It exploits the inter-muscular interval between the tensor fascia lata and the gluteus medius. If youve had a failed hip arthroscopy, almost certainly you also have acetabular pathology and a total hip rather than a partial hip replacement may give you a more consistent, longer-lasting and more perfect result. Also, when a single joint is replaced versus bilateral, there is significantly less bleeding and hence a much decreased need for transfusion. Testimonials 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. 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 Hip replacements might keep you out of action for a considerable period. How long will my hip replacement last in your opinion? Would appreciate any input you might have on the auto immune issue, and weight etc. Also, in the U.S., nearly all stems which are being implanted through the anterior approach are press-fit rather than cemented. There is also a small risk of death associated with any surgery. I wish you the best of luck with your care. In my experience, there is a faster and more-consistent recovery with the mini-posterior. A lot of hospitals and ambulatory surgical centers offer what's called outpatient surgery. My surgeon does the SuperPath method. In has been my experience in life that if others are happy and had a good experience then that speaks strongly to me, if I were to do the same thing. There are 5 questions, mobility, self-care, usual activities, pain and anxiety. It is critical to consider the pros and cons of each option before making a decision. 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. Notes on SuperPath experiences good or bad, https://patient.info/forums/discuss/superpath-experiences-good-or-bad-718788. A major hip replacement can take up to four months to fully recover from. Surgical Techniques Dr. Himmelwright Introduces SuperPath to OIP The most important thing is to get a top notch surgeon and go with whatever approach they offer. Dr. Sigmund holds a subspecialty certificate in Orthopedic Sports Medicine. 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. 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. Is it really as good as it sounds? Im not sure why you developed a problem with your IT band. The best of luck to you, These can include damage to blood vessels or nerves, dislocation of the hip, and infection. Only Dr. Leone will be using the most recent hip technique known as the SPAIRE technique as of 2020. The hip replacement needs to correct the abnormal hip mechanics that lead to the arthritis. Some in the early period have good track records, others do not. Publications Before proceeding, it is a good idea to review the recommendations and specific parts that your surgeon may recommend. Low-risk anterior approach patients are those who have significant deformities in their proximal femur as a result of previous trauma or dysplasia, or who have previously suffered from acetabular bone fractures. The posterior approach is used by a small percentage of people. 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. Other combinations of materials have advantages and disadvantages (for instance, some researchers believe that ceramic-on-ceramic types may be more durable, but they have also been known to make squeaking and popping sounds.) 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. As of 2020 only Dr. Leone is using the latest hip technique called the. Individual results and activity levels after surgery vary and depend on many factors including age, weight and prior activity level. I think it was sensible being careful on the other hand and I was told not to cross my legs. After reading a few articles on anterior vs posterior including yours, I know now that his decision to use the posterior approach is the best one for me! The anterior approach typically does not violate this structure. Due to security reasons we are not able to show or modify cookies from other domains. Does either procedure in this discussion present restrictions or advantages for this sort of movement? Your back does need to be evaluated as well. A THR is in my future. We fully respect if you want to refuse cookies but to avoid asking you again and again kindly allow us to store a cookie for that. Can You Use An Inversion Table With A Hip Replacement SuperPath experiences good or bad | Hip Replacement - Patient 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. After a slip and fall at work 2 1/2 years ago I need a THR on my left hip. Its been 8 months now. Dear Dr. Leone: There are potential drawbacks to anterior hip replacement. Call (919) 781-5600 to find out if you need total shoulder replacement in Raleigh, Cary, North Raleigh, Garner, or Holly Springs. Choose your surgeon and not the approach or prosthesis. During the procedure, the patient must have a small incision made in the side of his hip. But Im impressed with your blog and responses, so am writing to ask you about an apparently new procedure in which the surgeon uses a customised implant, utilising pre-operative 3D CT scanning. Its also reasonable to ask to speak to other patients who have undergone THR using this technique to learn about their experiences and results. SUPERPATH Hip Replacement | Bethesda Orthopaedic Institute SuperPATH Total Hip Replacement Phoenix, AZ | Total Hip Replacement Arizona Thanks so much for this information! If its a struggle, then the situation needs to be reassessed. While it is a surgery that does help many, many people, clearly you are struggling. If you would like a personal consultation, please contact our office at 954-489-4584 or by email at LeoneCenter@Holy-cross.com. I would focus on the individual doctor, not the approach that the individual choses to use, to deliver the best result. I am a South African and need to make a decision on whether my mother (69) goes for an AMIS or traditional posterior. Click to enable/disable _ga - Google Analytics Cookie. 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 . Over the years, these precautions and the length of time to adhere to these limits have been challenged both by clinicians and patients. Why I No Longer Use the Anterior Approach for Primary Total Hip If you would like a personal consultation, please contact our office at 954-489-4584 or by email at LeoneCenter@Holy-cross.com. There is no definitive answer to this question as different people will have different opinions and preferences. Risks associated with hip replacement surgery can include: Blood clots. It sounds as if you had a wonderful surgeon. Infection. SuperPATH showed better results in decreasing operation time, incision length, intraoperative blood loss, and early pain intensity. (PATH) and Supercapsular percutaneously assisted total hip (SuperPATH) arthroplasty: learning curves and early outcomes. What Ive seen in my practice is that the more total hips I do, the less restrictions I place on my patients and the more active my patients are. If I do a single hip or knee replacement, that patient is out of bed standing and, in most cases, walking the afternoon of surgery. The majority of teaching institutions in the United States continue to instruct as well as perform the traditional posterior as their primary approach. Pros and Cons of Hip Replacement Surgery | IBJI Time will tell if this generation of shorter press-fit stems fares as well. If your little voice is questioning if you are overdoing it or hurting yourself, then listen to it and ease up. This is not true for bilateral cases. Im hearing no restrictions (once recovery is done) for Anterior, but always some for the other two. Thanks! There are a few disadvantages to hip replacement surgery. Fortunately you live in a part of the world where there are many capable orthopedic surgeons. Ten years ago I had total hip replacement on the left at hss. External rotation of your feet should be limited (avoiding them twisting to the outside as Charlie Chaplin does) and hip hyperextension should be avoided. Because of the straightforward exposure of the femur, there is less risk of femoral fracture or poor implant positioning. 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. Any feedback will be appreciated. I dont want a long recovery time as I am very active. I do participate in competitions and showcase presentations. Because the muscle fibers are separated, not cut, the nerve path is not disturbed and the muscle is not injured. When the capsule is fully healed, it forms strong ligaments that will eventually regrow (it will take about 4 months for the capsule to form again). Should I be though? Nerve regeneration can occur up to 18 months following injury, but the chance of full recovery decreases with delay in recovery time. I also regularly receive Rolfing treatments which has helped me manage pain and maintain what mobility I have. But this blog was a nice nudge toward the posterior. This robotic technique can assist in producing an excellent result. It seems that whatever their particular approach is that is what they sell. When discussing the options, my surgeon all of a sudden suggested performing anterior approach. Advantages of an anterior approach to hip replacement A major muscle is not cut during the anterior procedure. 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. Select a surgeon based on your impression of that individual: how engaged was he or she in your care, will you have access to that person as well as his or her team before and after surgery? About how much does this cost? Just because hardware in your foot needed to be removed after repairing what sounds like a calcaneal (heel) fracture, absolutely does not mean that your body rejected the metal / hardware or that your body will reject the prosthesis your surgeon will implant to reconstruct your hip. Today, everything from tools to techniques has improved. If your surgeon cant answer your questions about hip replacement or provides unsatisfactory answers, you may need to consult another surgeon. 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. Thank you for this! Soft tissue contractures often are associated with long-standing arthritis. An anterior hip replacement is not covered by a specific credential system for orthopedic surgeons. I also think its reasonable to look forward to returning to all of the listed activities that you enjoy. I then would strongly suggest you trust that person to decide what approach and what prosthesis predictably will deliver the best results. Your article is the first Ive read in which no muscle or tendons are cut in any approach other than the direct anterior approach. 5. Since these providers may collect personal data like your IP address we allow you to block them here. Typically, most are eager to go home the very next day; many have already progressed to a cane, which they will not use very long. An artificial joint is used to replace the worn out hip joint during a hip replacement procedure known as posterior hip replacement. I love that you take time off to reply to these messages it is commendable. disadvantages of superpath hip replacement. I am so sorry to learn that you are struggling. Mine certainly have. Also, some body structures or anatomy makes approaching a hip anteriorly much more difficult than others. 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. Ken. It is critical at time of surgery that an excellent range of motion be created without impingement. I dont know what happens on that tablewas he in a hurry on Friday afternoon. Dr. I am a 73 year old woman who has been having severe hip pain for the last seven months. They also are looking into methods to reduce the risk of infections in artificial joints. Also, is it immoral for an 80 year old to have THR and cost the nations health care system $25 $35k? Having a THR is a major undertaking and it is reasonable to expect the hip construct to function optimally for twenty and more years. I had an anterior right hip replacement in late 2010, I was 72. Do I have a high percentage of hip dislocation after a 2nd revision done posterior way if so what is my chance of another hip dislocation even if I do the surgery again? 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. In addition, patients prefer the anterior approach due to the absence of pressure on the Femoral nerve in the anterior approach. 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. Are my findings that posterior approach in my situation would have been more appropriate? I needed no physical therapy at all. There is less risk of neurological injury. Minimally invasive versus standard incision anterolateral hip replacement: a comparative study. Operating through too small an incision and not releasing tissue that would improve exposure and result in a more balanced joint in my opinion does a disservice. Proponents of minimally invasive hip replacement say small-incision operations can lessen blood loss, ease post-operative pain, trim hospital stays, improve scar appearance, and speed healing.. It normally takes about 3-6 weeks to resume normal household activities and about 12 weeks to resume recreational activities like bicycling or golfing. I am a sixty five year old active male and need THR on my right hip. 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. He is one of the few surgeons in the U.S. that performs total hip replacement via a superior capsular approach, the most soft tissue-sparing hip replacement available and is an industry educator in the . Remain upright . 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. The pain in my hip is strange in that I can hike uphill and down hill, bike and X-country ski but have a very hard time walking on the flat, especially after sitting for awhile or getting out of bed. I ski, hike (steep terrain) with a pack -about 25 pds, kayak, horse back ride, swim, water ski and bike, which is getting increasingly more difficult. I spoke in person to probably 4-5 of his success patients and went with hearing from them. The vascular supply of your leg must be assessed preoperatively as part of you work-up, but most do very well.
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