(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. Between your legs, you should sleep with a pillow for the next six weeks. If a revision were necessary, even more bone must be destroyed to remove it. Historically, higher dislocation rates were reported with the posterior approach, but it still was used for its many other advantages. 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. It normally takes about 3-6 weeks to resume normal household activities and about 12 weeks to resume recreational activities like bicycling or golfing. No, I would not tolerate the pain and immobility, if there is a reasonable way to relieve it. The amount of PT you need after surgery will be determined by you and your surgeon. I typically do hip replacement on the get anterior approach in 90% of my patients. I don't think there's a one size fits all when it comes to hip surgery. 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 am terrified of nerve damage as I am very athletic and a previous professional ballet dancer. I seem to be able to hike just fine up hill and down but not always on the flat. After awhile the screws started shifting and poking up under the skin and they removed them. Remain upright . Thanks! The idea is it should be a little less painful if the muscle, tendons and nerves are not disturbed. Does my prothesis not last as long since I am now doing a 3rd surgery? 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. If you decide to have your hip replaced in another country, I would consider carefully who would care for you if you develop a complication such as an infection, or a major medical problem like a pulmonary emboli or heart attack after surgery. 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. Download scientific diagram | (a) Components of a total hip replacement; (b) The components merged into an implant; (c) The implant as it fits into the hip [15]. Sometimes the pain goes away as I walk and sometimes it doesnt. Still going to rehab to reduce stiffness and increase strength but I am in better shape now than before surgery. Do you have any advice or ballroom dancer THR stories to share? If theyre really happy and got well quickly, you probably will too. In hopes that THA would let me live my normal life without arthritis, instead I can barely walk more than 100 yards without having to stop, my gait is crooked causing lower back problems and my personal life is less than perfect. 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. I am having the mini posterior done in June and my surgeon gave me the pros & cons of both. There is a chance of nerve injury with any type of hip replacement. I had the surgery on June 22 and I am about 5 weeks post op. United States. Although anterior approaches can be useful for some, they are not for everyone. As you can see, there are no restrictions. In the dark to find out about this myself. I often suggest to my patients that they speak to other patients for whom Ive cared and to whom they can relate to learn about their experiences. Our clinical information meets the standards set by the NHS in their Standard for Creating Health Content guidance. Since I previously had both knees replaced (by another surgeon) about 5 years ago and still have problems with the knees i.e. The doctor is planning a traditional posterior. This procedure differs from traditional hip replacements in the following ways: There is no surgical dislocation of the hip. Your out-of-pocket costs for your hipreplacement will be impacted by a number of . I had no inkling of this till he showed me on the x-ray. Once youve decided, you then need to trust that he or she will take the best care of you possible to deliver the best results. I wrote to you in January, now my surgery is in a couple of weeks. As of 2020 only Dr. Leone is using the latest hip technique called the SPAIREtechnique where patients no longer have hip precautions after surgery. This complete wall of tissue that surrounds the new hip imparts stability. Many of these stems have very little if any long term follow-up, although some appear to be doing well in the short term. I have seen 4 surgeons. appropriate medical assistance immediately. I, personally, have not had a patient dislocate following a primary total hip replacement in many years. It sounds like he did fabulous job. Its Inosine and Sphingolin. More soft tissue trauma can result do to this increased difficulty in exposure and then gaining more exposure if necessary. Dear Dr. Leone, It can lead to numbness in the thigh and, in rare cases, skin irritation due to the nerves presence. I find it curious that you report having a good result for the first five months after your surgery as this suggests that the surgery was done for the right indication, i.e., you did well and were pleased for the first five months after THR. In my practice, I cement an Exeter stem in a significant percentage of my patients who undergo THR . 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. 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. This is particularly true if the person is overweight, has very muscular thighs or is short. 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. We are an online blog dedicated to providing comprehensive and accurate information about orthopedics and injury prevention. Im a 50 year old female whose been dealing with hip, leg and back pain for many years, recently diagnosed with OA, and finding that I need a right THR. Thanks. (I have SCD) It has now become unbearable and I am preparing for surgery. This approach has a number of potential advantages, including a shorter hospital stay, less pain, and a quicker recovery. I have many patients who are accomplished and passionate ballroom dancers. 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. Since these providers may collect personal data like your IP address we allow you to block them here. 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. Thank you for sharing. The most important decision you must make is choosing your surgeon. There are hybrids of the surgey from what I can see. Can I expect any problems with the bilateral it was my choice. I wish you the best of luck with your care. I have dealt with my hip pain and limping for over a year, can no longer perform my daily activities, and cannot sleep well anymore. It's a hip replacement surgery where you lie on your side. Recently the doctor doing anterior decided because of thin bone, he should do direct lateral approach. Almost all bilateral THR or TKR patients go to a rehabilitation facility after their acute stay, not home. Gary. The SuperPATH technique is arguably the least invasive hip replacement technique. A number of patients who have undergone this procedure are able to walk unassisted the day after surgery . It is nice to see honest Q&A versus a marketing page. Dont let PR marketing confuse the big picture. An operating room that can support safe Anterior or SuperPATH minimally invasive joint replacement surgery costs around $1.5 million. What Ive been able to achieve is find two nerve supplements that have taken away the burn/tingle on my thigh. What is SuperPath Hip Replacement? If so, is it possible to have both hips done at the same time? Clearly, he or she has earned your respect and confidence. 3 years ago, Thank-you. I am female and I weigh 115 pounds. You are to be commended for taking the time to answer our questions. Therapy is often appropriate for stretching, strengthening and electrical stimulation which helps maintain the motor end plates, structures on the muscles that the nerve branches must re-innervate. 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. You can resume your active lifestyle as soon as possible thanks to a new prosthetic hip. . The anterior approach exploits an interval between muscles that cross the front of your hip and thigh. The surgeon accesses the hip joint from the front of the hip, rather than from the back or side. All of these releases may be necessary as part of the surgery and patients do well. 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. In my experience the approach used to replace a hip does not effect how quickly a patient recovers. Im sorry to hear that you struggled after your first, anterior-approach THR. Changes will take effect once you reload the page. You always can block or delete cookies by changing your browser settings and force blocking all cookies on this website. There is a chance that the hip will fall out of the socket, or that it will be levered out by twisting it. posterior surgery . If you have an abnormal anatomy or are morbidly obese, you may not be a good candidate. I wish you only the best, Welcome to Brandon Orthopedics! Once you find that doctor, then you need to put your trust in him or her to help you solve this horrible problem so you can return to being active and productive. Currently, I seldom do bilateral THRs under a single anesthesia but instead stage the surgeries 2 1/2 to 4 weeks apart, depending on my particular patient and his or her needs and desires. Im ready to have the surgery, having been basically bone on bone for several years. The technique allows recovery that is as rapid as a mini-posterior approach while conferring stability of the hip joint that is equal to other exposures that . disadvantages of superpath hip replacement. I did have numerous blood tests, MRI of knee and hip, total body scan with radio active injection, X-ray knee and hip etc. Honestly, most 59-year-old active women do best with a well done THR. Finally, I would choose a doctor with whom you connect and whose staff is engaged and knowledgeable. Thanks. Thank you for this information. Report / Delete Reply kelly1010 nicole66881 By far the most important variable is the doctor who is doing your surgery and managing your post-op care. 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. I also would encourage you to choose your surgeon first not the procedure, approach or prosthesis. I am 56 now and find that physical therapy and chiropractic care dont seem to be helping anymore. I went with a total hip replacement. There are numerous complications associated with hip replacement surgery, but blood clots in the legs and hips are two of them. 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. Often in this group of patients, their X-rays show only minimal cartilage space compromise (it may appear thinned and irregular) and I observe at time of surgery that the labrum appears hypertrophied (to compensate for lack of head coverage) and often torn. This is not true for bilateral cases. Bleeding at the operative site can occur as a result of an anesthesia reaction, such as an allergic reaction. Any feedback will be appreciated. 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. I was told the joint lubricant had migrated into the hip bone creating the cyst, There is effusion in the joint and stress areas. Also had There arent any activities that you can do with a resurfaced hip that you cant do with a total hip. emergent norm theory quizlet. They thought surgery to repair it would give me about 5 yrs. 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. I also would learn about the track record of the surgeon and hospital where you will decide to have the surgery and what implant will be used. Im 56 years of age, 6 1 and 180 pounds. Disadvantages of the anterior approach include: The nerve which supplies sensation to the front and side of the thigh is vulnerable. It does mean the surgeon has lots of room to move about though!! Lastly, where can I find a great surgeon that takes FL Workmans Comp? 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. Every surgery should be done with as minimally invasive approach as possible taking into account these other critical factors. (PATH) and Supercapsular percutaneously assisted total hip (SuperPATH) arthroplasty: learning curves and early outcomes. In a posterior hip replacement, the procedure is done on the side of the hip. Also, some body structures or anatomy makes approaching a hip anteriorly much more difficult than others. I do not have dials and no one seems to know where the neuropathy stems from. Fortunately, many folks who experience back symptoms before THR report improvement or resolution after. Very sorry to hear of the difficulties you experienced! Getting in and out of cars, and turning over in bed. Are these expectations realistic? I wish your patient well. I would encourage you to discuss your concerns with you surgeon. Patients can also have as little as a 3-inch incision. J Orthop Surg Res. Dr. Leone, I am coming in to see you for an appointment for a THR to my left hip. I think they are happier and rehab more quickly. Following anterior hip replacement surgery, avoid soaking in hot tub, sauna, or swimming pool immediately after surgery. Have you heard of something like this, and if so, is it worth it? Why is that? For many years, I performed bilateral THR and bilateral TKR procedures, but have backed away for a variety of reasons. I spoke to the surgeon, he believes it may take up to 6 months to get better from this neuropraxia. 2015 Aug. 3 (13):179. The mini-posterior is considered a more straightforward approach then the anterior, resulting in lesser complication rates. 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. The posterior approach is used frequently again, in large part due to the fact that it is an extensile approach. Publications Technologies, The Leone Center I am very athletic and active even with many years of pain from bone on bone arthritis so I am worried about restrictions since Ill probably forget or something. No one tells me the same thing? Thanks again! Sitting seems to irritate it the most. 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. Pain Management I think it was sensible being careful on the other hand and I was told not to cross my legs. My legs are very muscular and trim. An anterior-approach hip replacement necessitates a small incision in the groin area on the front side of the leg. What is most important is that you find a surgeon who understands the particular complexities with your problem and whom you trust. With mild dysplasia, positioning and implanting the new cup usually is not more difficult than with other conditions. I am now bracing myself for THR surgery within the next year and am wondering if there is any big advantage in trying to have this done by a surgeon who offers the customised implant, as above. He is the founder and main author of brandonorthopedics.com, a website that offers valuable resources, tips, and advice for patients looking to learn more about orthopedic treatments and physiotherapy. Adults of any age can be considered for a hip replacement, although most are done on people between the ages of 60 and 80. My strategy is to make as small an incision as possible, but one that allows for excellent exposure and reconstruction without brutalizing the tissues. What to Expect From what Ive seen, most THR patients dont need very much PT, although I do encourage exercising in a pool. 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. Thank you very much for taking time to reply me. Im so pleased to learn that you had a good experience. There are many factors that contribute to whether or not someone is a good candidate for anterior hip replacement surgery. Reconstructing the opposite hip hopefully will result in legs that feel more equal. I am a very active and young 69 year old female who had a THR on my left side 5 years ago. This risk is greatest in older females with bone of sub-optimal quality. I havent dropped in here for a while but here I am almost 5 yrs post op Anterior and Femoral Nerve Damage is very alivewhole thigh is numb, IT band is still very sore and numb.

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