I now need the right hip replaced. Testimonials This too will lower your anxiety and improve your experience. I thought the newer procedure on the special table was the best way to go. Above the ankle to the thigh.Had to use leg brace to I had the mini-posterior at MGH hospital. 3 years ago, Almost all bilateral THR or TKR patients go to a rehabilitation facility after their acute stay, not home. I am a 73 year old woman who has been having severe hip pain for the last seven months. The leg lifts really aggravate the front of the hip. Fewer narcotic medications are administered, resulting in a better overall recovery. An anterior hip replacement is, in many ways, less risky than any other type of hip replacement. The anterior approach is not as muscle sparing as some would argue. That's all I know. Its been a couple months and I thought Id drop in with an update..over 4 yrs post op and I deal with Femoral nerve damage from Anterior, and found others who deal with the same.it may lessen with more years but who knows.Somewhere I read 15% or so end up with this..I talked 2 other people in my city, same surgeon and they have had this issue to. Most patients after a bilateral procedure would not go home but rather a rehab unit. Walker to get around. The surgeon I saw said that my body structure and gait does not affect which approach would be ideal for my body. When it comes to revision surgery, we rely heavily on the posterior approach. He is highly respected by the medical and chiropractic community, so i plan to have a appointment to discuss his plans for my surgery. Please comment. In the hands of a master, all can produce wonderful and predictable results. A femoral nerve injury is devastating and is more vulnerable during an anterior approach than with other approaches. We have an appointment today to discuss the plan of action. and Privacy Policy and steps will be taken to remove posts identified Infection. A couple of things I am hoping you will explain using laymans termology. I decided to stick with my trusted orthopedic surgeon (who did two knee scopes on me) who believes the minimally invasive posterior approach is the safest approach. This procedure differs from traditional hip replacements in the following ways: There is no surgical dislocation of the hip. After reading your article I am concerned about the issues you discussed. You can resume your active lifestyle as soon as possible thanks to a new prosthetic hip. I am wondering if having mild hip dysplasia is a factor in which approach is used. Both have valid cons against the others methods and pros on their method. 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. If I have a 2nd revision of my right hip is it posterior approach or the mini-posterior approach as you discuss above? I was told the joint lubricant had migrated into the hip bone creating the cyst, There is effusion in the joint and stress areas. I try not to let it get to me, but it causing me to feel handicapped. Additionally, people with certain health conditions such as diabetes or heart disease may also not be good candidates. Thank you. By 2016 and over 300 SuperPATH cases, the results of very first 100 SuperPATH surgeries (the so called 'learning Curve') were published in a peer reviewed journal with . Being cared for in a hospital that specializes in joint replacement and has an extensive specialty medical staff also is key. That being said, you should have the additional surgery where you feel you will have the best chance of doing well. OTC nerve supplements suggested by a naturopath. 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. Many manufacturers are responding to the surgeons desire for shorter stems and many are now available on the market. Femoral nerve function also should be assessed. Overall, it sounds as if youve had an excellent result and wonderful recovery following your hip replacement. Hip replacements might keep you out of action for a considerable period. With degenerative osteoarthritis of the hip developing secondary to a severe slipped capital femoral epiphysis (scfe), recreating normal hip mechanics after THR may have necessitated lengthening the first hip. 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. I just had mine 10/30 all I can say is be patient get lots of rest and take your pain meds way before you start to move around so that the pain want be so bad with movement. I deal with OA lower back mess so know I see most likely how all this has played into the surgery. This technique is also referred to as the . Even after the procedure is completed and the patient is on pain medications, pain and discomfort may occur in some cases. If I can put you on the spot. Have you recovered by now? I prefer reconstructing the most symptomatic side first. It sounds as if you had a wonderful surgeon. That's all I know. Gary. The anterior approach has a lower incidence of sciatic nerve injury and a higher incidence of femoral nerve injury. I am 5 weeks out and have been doing beautifully! Supercapsular Percutaneously-Assisted Total Hip surgery or SuperPATH surgery is a novel method of hip replacement where your surgeon can perform total hip replacement through 2-3 inch incision into the tip of the hip and without dislocating the hip or damaging the surrounding soft-tissue (muscles and tendons). 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. That being said, if the foot is now a much bigger problem than the hip, you may have to deal with that first. Some patients who have recently had anterior hip replacement may suffer from complications such as wound healing. Yes, you can do very well. The hip is replaced without the need for surgery to dislocate the joint. It is not a substitute for excellent surgery. The anterior hip can be easily and naturally recovered by walking, simple home exercises, and isometric exercises. Most individuals who have had total hip replacement surgery fall into this category and simply resume their lives.. What is your experience and take on this ? This does expose the patient to more radiation but can help with component positioning and sizing. The hope is that your nerve injury will recover with time. My legs are very muscular and trim. Each surgeon approaches these issues individually. Time will tell if this generation of shorter press-fit stems fares as well. A major muscle is not cut during anterior hip replacement surgery, so pain is reduced and major muscles are not cut after the operation. Traditional Hip Replacement - Traditional surgery requires a large incision of 10 to 12 inches and detachment of muscles from the hip. I actually was supposed to get both done at roughly same time but its been 3yrs with this bad right hip, mainly i was in great fear of going through that pain again, but now i think that pain will be better than this everyday pain!! For centers like Phoenix Spine and Joint that use a robot, there is . A hip replacement can be delayed until it is absolutely necessary if the replacement parts can fail over time. Some people also tend to form scar tissue and contracture more readily than others. Currently, the incidence of dislocation after the posterior approach has been greatly reduced due to technique and other refinements. This interval must be developed and the muscles must be separated in order to reconstruct the hip. 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. Dr. I am a 53 year old active, distance runner. Additionally, there is a small risk of dislocation after surgery, which can be painful and may require additional surgery to correct. Dr. Leone, I am coming in to see you for an appointment for a THR to my left hip. The approach planned is a frequent topic of Continued It is critical that the patient is aware of the risks, benefits, and alternatives of the procedure. 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. 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 . 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. All rights reserved. Dr Leone, you make the point several times that the surgeon, not the procedure is most important. I had a posterior, the surgeon did not cut any muscle, they just move them now. Intervals between muscles are separated or muscles are separated in line with their fibers without injuring the muscles innervation. Thanks again! Do either of your techniques require the traditional anterior or posterior precautions? 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. I am suffering from a severe range of motion where I cant put my left sock on or tie my left shoe, I can barely get in and out of low cars and sitting up at a table hurts too! It all comes down to the surgeons comfort as well as the patients. So my concerns include having the range of motion to perform moves like promenade where my body is roughly facing forward and my right leg will take a step left across my body at about 90 degrees. You can do anything you want after a hip replacement. I am a South African and need to make a decision on whether my mother (69) goes for an AMIS or traditional posterior. 5. The anterior approach typically does not violate this structure. Thanks! I think cutting muscle was in the past. Every hip implant has benefits and risks. Had a total hip replacement aug 2013. There does appear to be an increased incidence of stem instability when implanted through the anterior approach, but I believe this is largely a function of the surgeon experience. Because the patient is lying on his back during the procedure, fluoroscopy or moving x-rays are used to aid in the examination. Dr. William Leone, Hello Dr. Both of these are very successful ways of doing a hip replacement. I am 56 now and find that physical therapy and chiropractic care dont seem to be helping anymore. I choose to do them in a staged fashion because it is a significantly shorter procedure (more than half time-wise) and some think this lessens the risk of infection. 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. 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. How would a hip replacement be done? 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 always refining and trying to make it better. 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. The most common reason or diagnosis that leads me to replace the hips of young women is hip dysplasia. The SUPERPATH technique is a tissue-sparing procedure which aims to get patients back on their feet within days (possibly hours) instead of weeks or months. Possibly, its secondary to an altered gait pattern or hip mechanics. I am already limping when walking and was hoping that the limp would disappear after the hip surgery. Not sure exactly what that means. Glazener C, Fraser C, Hutchison J, Vale L. Single mini-incision total hip replacement for the management of arthritic disease of the hip: a systematic review and meta-analysis of randomized controlled trials. The nerve which supplies sensation to the front and side of the thigh is vulnerable. Welcome to Brandon Orthopedics! Even a task as simple as putting on socks and shoes can result in debilitating discomfort when a severely damaged or arthritic hip is involved. It's a hip replacement surgery where you lie on your side. They are addictive, can cause depression, their analgesic effects are short lived and if the condition persists, you will require an increasingly higher dose to relieve the pain. I would rather see my patients go home. Diagnosed possible labral tear. The SuperPATH technique is arguably the least invasive hip replacement technique. Also, in the U.S., nearly all stems which are being implanted through the anterior approach are press-fit rather than cemented. This is not true for bilateral cases. This is because the nerve is located in front of the hip. I have not seen this before because in the past, the complication from hip surgery were sciatic nerve injury from posterior approach. If your little voice is questioning if you are overdoing it or hurting yourself, then listen to it and ease up.