Click to enable/disable _gid - Google Analytics Cookie. Over the last six years, I have performed more than 2000 primary or first-time total hip replacements using the mini-posterior approach and I am aware of only one patient who dislocated his hip because he fell down stairs. 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. They are encouraged to be very active and most stop using a cane, can drive their cars and are exercising in the pool, just two weeks after surgery. Some patients have no pain at all, which is remarkable. Many believe that this results in less risk of infection. The anterior hip can be easily and naturally recovered by walking, simple home exercises, and isometric exercises. A ceramic-on-ceramic bearing is also a very good bearing. Even in my practice, which is starting its 27th year, we continue to refine the surgical procedure, pre- and post-operative instructions and rehab (this is huge), pre- and post-operative pain management, and even anesthesia. 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. The information I have gathered seems to indicate the anterior approach is more inherently stable, making precautions unnecessary. The surgeon does about 200 a year and people say he has a good reputation. I ride horses, water ski and kayak. Some of the most common considerations are age, weight, activity level, and the presence of other health conditions. As a result of this precaution, it is difficult to sit on low chairs, sofas, or toilets. 1000 NE 56th Street, Im ready to have the surgery, having been basically bone on bone for several years. The main limitation after surgery is a lack of comfort. Once the surrounding tissues fully heal, they then act as a mechanical block to the ball to keep it from being able to jump out.. I was so against doing this surgery but groin pain was very bad and crushed bone in the groin. We want the forums to be a useful resource for our users but it is important to remember that the forums are I prefer reconstructing the most symptomatic side first. Studying a hospital and physicians track record before you commit is important. 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. Six months ago I had a right posterior THR due to severe scfe; now my right leg is 5/8 longer than my left leg. Registered in England and Wales. In my experience, usually releasing the ileopsoas tendon insertion onto to lessor trochanter and medial hip joint capsule, and then manually stretching the leg into an abducted position after THR reconstruction, obviates the need for formal release. 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. Hip replacement - NHS I did have a total knee replaced two years ago. Each approach has advantages and disadvantages. 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. I am deciding that my quality of life is in the toilet and need to get the THR done. as being in breach of those terms. These can include damage to blood vessels or nerves, dislocation of the hip, and infection. What are your thoughts on the use of robotics? Should one of these events occur during a mini-posterior procedure, they are easier to recognize and correct. 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. SuperPATH showed better results in decreasing operation time, incision length, intraoperative blood loss, and early pain intensity. A THR is in my future. If was 3 weeks after discharge The mini-posterior is considered a more straightforward approach then the anterior, resulting in lesser complication rates. My surgeon is doing posterior and my reason is I am self employed with limited Time off available and hope to be back to work at least walking and driving in 4 to 5 weeks is this possible? Recently the doctor doing anterior decided because of thin bone, he should do direct lateral approach. After a slip and fall at work 2 1/2 years ago I need a THR on my left hip. If you are minimally handicapped with discomfort from the non-operated hip and the leg length difference is tolerable or easily managed with a shoe lift or modification, I would consider waiting. (a) Components of a total hip replacement; (b) The - ResearchGate I am female and I weigh 115 pounds. Thank you, Lisa. Optimal component positioning also is critically important for the best stability and longevity. Also had The traditional posterior approach is the most commonly used in the United States and throughout the world (about 70 percent). I have had problems with my hip for the last several yrs. I am a 49-year-old female. It's cut off and removed through the hole. I dont think one surgical approach is better or worse than the other for you to accomplish this. 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? Surgical Approaches To Hip Joint Dr. Apoorv Jain D'Ortho, DNB Ortho . from publication: Current and . This is used when the cartilage in the hip is severely damaged by osteoarthritis or other conditions. Each question is scored from 1-5, with 1 being no problems and 5 being severe problems. 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! Patient aims to help the world proactively manage its healthcare, supplying evidence-based information on a wide range of medical and health topics to patients and health professionals. These parts have a porous coating that the bone grows into. 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. 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. 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. Im hearing no restrictions (once recovery is done) for Anterior, but always some for the other two. Dear Dr. Leone, Currently, the incidence of dislocation after the posterior approach has been greatly reduced due to technique and other refinements. I would stay away from narcotics. Hospitsl staff Both approaches have been shown to have potential in research. Need to choose, then select doctor based on that decision. SuperPath Tissue Sparing Hip Approach | MicroPort Orthopedics I worry that replacing it with a differently configured socket could make things worse rather than helping. I play in the 50s age group. Also, be aware that as the nerve recovers, the smallest C fibers within the nerve recover first, which can cause a burning discomfort. Recognize that the underlying etiology is not being corrected by this procedure, so relief of symptoms probably will be temporary and possibly partial. 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. With SuperPath, there is no surgical dislocation of the hip. Unfortunately, short of conservative and supportive measures, only time will tell. One of the biggest changes that Ive seen in my practice over the past 25 years is how quickly patients get well and go home. Pain modifying drugs as well and as a course of NSAIDs might also be appropriate. 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. Otherwise you will be prompted again when opening a new browser window or new a tab. For centers like Phoenix Spine and Joint that use a robot, there is . I walk a lot in my job and bend lots (work with children) and sitting causes pain due to impingement. Traditional Hip Replacement - Traditional surgery requires a large incision of 10 to 12 inches and detachment of muscles from the hip. 2004 Apr. I had an MRI by a different hip doctor (a preservationist) who diagnosed me with a birth defect (hip dysplasia). Anterior hip replacement has the potential to cause complications and pose some risks. I would look at the published track record of the hospital where the surgery is scheduled to be sure its performance record is good and its incidence of infection is low. The first step to rule out infection is to have two simple blood studies done, an ESR and CRP. Posted Cons of Robotic Assisted Surgery As with any type of procedure, Mako is not without its drawbacks. Third, the procedure is shorter in length and requires less hospital stay than traditional hip replacement surgery. I am a very active and young 69 year old female who had a THR on my left side 5 years ago. disadvantages of superpath hip replacement The vast majority of my patients return to work one to three weeks post-operatively. daniel neeleman net worth . My clinical impression is that more patients experience some degree of residual groin discomfort or tightness after the anterior approach as compared to the posterior approach, but that it tends to resolve with time. I was out of bed walking around the evening of the surgery . I have linked back to several blog posts below that will give you more in-depth information. 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. Le has extensive experience in primary joint replacements, complex revision surgery, periprosthetic fractures, and infection management. I wrote to you in January, now my surgery is in a couple of weeks. These positions include crossing your legs, bending your hip more than 90 degrees, or lying on your stomach. Tina, which procedure did you have? and Privacy Policy and steps will be taken to remove posts identified It can lead to numbness in the thigh and, in rare cases, skin irritation due to the nerves presence. Lazaru P, Marintschev I. 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. I am 56 now and find that physical therapy and chiropractic care dont seem to be helping anymore. The posterior approach, then, is less inherently stable but may or may not require precautions. As for doctors, the surgeon I had came highly recommended. I would not recommend pushing your surgeon to use one specific approach or another. By far the most important variable is the doctor who is doing your surgery and managing your post-op care. That said, in general people who are longer, more flexible and thin are more easily constructed anteriorly than individuals who are very stiff, contracted, thick, and have acetubular protrusion (a condition when the femoral head wears away the central cartilage and bone of the acetabulum). I am scheduled to have total hip replacement surgery in 2 weeks. Dr. Leone, I am coming in to see you for an appointment for a THR to my left hip. A modern artificial hip joint is designed to last for at least 15 years. I wish your patient well. A orthopedic surgeon may insert a numbing agent directly into a new joint, which can last up to 48 hours. Comparison of short-term outcomes between direct anterior approach (DAA Thanks! According to Dr. Rosen, the most important thing to remember is what you leave behind rather than how you get there. Note that blocking some types of cookies may impact your experience on our websites and the services we are able to offer. How Much Does Minimally Invasive And Robotic Hip Replacement Surgery THOUGHTS? Patients who have this surgery no longer require walkers, canes, or other aids 5 to 7 days after the operation, in comparison to those who have hip surgery. For many years, I performed bilateral THR and bilateral TKR procedures, but have backed away for a variety of reasons. Thank you. Even after the procedure is completed and the patient is on pain medications, pain and discomfort may occur in some cases. The following cookies are also needed - You can choose if you want to allow them: You can read about our cookies and privacy settings in detail on our Privacy Policy Page. There is also a risk of the hip joint not fusing correctly, which can lead to pain and instability. Most traditional hip replacement models are metal-on-plastic varieties. Other jobs, which tend to be more structured and / or more physical, may require more time off. Hip Replacement Surgery | Superpath Hip Replacement Sydney Australia We need 2 cookies to store this setting. Many studies suggest that any limp or clinical weakness resolves after approximately three months. During anterior approaches, fracture repair is much more difficult and necessitates the use of a separate incision. I had to cut some strength exercises out leg lifts, hip sled. 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. Dear Jo Anna, Help. 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. My walking is very limited, shoe is built up as leg is shorter and in recent months Ive realized my leg is bowed. Im getting close to needing my left hip done. Also, is it immoral for an 80 year old to have THR and cost the nations health care system $25 $35k? Better luck to you all. After reading your article I am concerned about the issues you discussed. The most important thing is that tissue is handled gently and trauma is minimized, whichever approach is used. The SuperPATH Hip Replacement: A Novel Less Invasive Radid Recovery 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. Sometimes the pain goes away as I walk and sometimes it doesnt. In bed for long periods with little or no movement. On July 17th, I had a left THR. I don't think there's a one size fits all when it comes to hip surgery. There is a chance of nerve injury with any type of hip replacement. This complete wall of tissue that surrounds the new hip imparts stability. Many patients approach this by researching online and speaking to other patients who have been cared for at a particular facility. I assume PTHR is referring to partial hip replacement. Egton Medical Information Systems Limited. 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). 2015 Aug. 3 (13):179. I had posterior and much like the superpath trussed into the jig . The surgeon I am meeting with (Dr Jimmy Chow) is supposed to be top notch in this procedure, and I am just curious as to how different the surgery is from conventional surgeries. Obese or extremely muscular people may not be the best candidates for this surgical procedure.