It sounds as if you had a wonderful surgeon. Recognize that the underlying etiology is not being corrected by this procedure, so relief of symptoms probably will be temporary and possibly partial. Very sorry to hear of the difficulties you experienced! Because of the restricted view provided by the anterior incision, the anterior incision is a technically demanding procedure. I have a tilted sacrum, sway back and a very large posterior. Im 51, 59 and 148 and want to get back to tennis etc, this has been long frustrating process. 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. If the tissues are traumatized and / or the final components are not optimally positioned, then it certainly is not an advantage. Just need reassuranceI am stressing he is fine. He is well known as a top doc for 20 yrs & I was persuaded because the mini posterior has less chance of nerve damage & the surgeon has more options for types of spikes, which your article explains well. By continuing to browse the site, you are agreeing to our use of cookies. The first is that it is a major surgery, so there is a risk of complications such as infection. Very important with both the traditional posterior and the mini-posterior approaches, if the surgeon is not able to visualize critical structure adequately, or if a problem were to arise such as a fracture, then either approach can easily be adjusted. No groin pain NOW.but all the other mess of it all. Being out of bed and moving soon after surgery adds to a patients safety and speeds the recovery. 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! Potentially there also is less pain and a quicker recovery. 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. Because the dissection is over the front of the hip, a number of patients will experience residual pain and tightness anteriorly (in the front of the hip) at least early on. I have two questions one, how realistic would it be to try to have both hips done at the same time? The incision made for the operation can be as small as three inches. 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. On the other hand, there may be a slightly increased incidence of anterior instability. I take care of many individuals who have a total knee and hip replacements on the same side. The anterior approach, as a marketing tool, has grown in popularity among surgeons. Sitting seems to irritate it the most. There is also a risk of the hip joint not fusing correctly, which can lead to pain and instability. Because the anterior hip replacement surgery is a minimally invasive procedure, no cuts are made to the muscles surrounding the hip. I am a!so told by the orthopedist who referred me that I need arthroscope on my right hip. The anterior approach has a lower incidence of sciatic nerve injury and a higher incidence of femoral nerve injury. I had the mini posterior approach done and it gets better everyday. What is most important is choosing your surgeon. Publications It is so important to stay focused on the outcome of your hip replacement surgery: excellent results both short- and long-term with minimal risk of injury or complication, and not lose sight of the real goal, which is to create a perfectly positioned reconstructed hip that is stable, balanced and has the best possible chance of lasting more than twenty years. I have the hospital but am deciding on the surgeon and which approach is best. Will I still be able to do all of these things? Apples to apples which procedure has the lowest incident of complications? I also think infection must be investigated and ruled out. 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. I emphasize continuing exercises at home especially walking. I had an MRI by a different hip doctor (a preservationist) who diagnosed me with a birth defect (hip dysplasia). My main concern is that I have a tilted sacrum and a very sway back. 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. Does the mini posterior hip replacement conserve more femur and allow for future surgeries if needed ? I also regularly receive Rolfing treatments which has helped me manage pain and maintain what mobility I have. Less tissue damage during surgery allows for a much faster recovery and no restrictions in range of motion when compared to traditional hip surgery. 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. I had my hip scoped which bought me 8 years, but need a THR now. Because the patient is lying on his back, it facilitates using a fluoroscope or moving x-ray throughout the procedure. External rotation of your feet should be limited (avoiding them twisting to the outside as Charlie Chaplin does) and hip hyperextension should be avoided. 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. 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/Leone-Center-Logo@2x.png, The Pros and Cons of Two Approaches to Hip Replacement: Mini-Posterior and Direct Anterior, Copyright 2018 - 2023 The Leone Center for Orthopedic Care. Finally, hip replacement surgery is expensive and may not be covered by insurance. more nutritious, too. This is because the nerve is located in front of the hip. Are these expectations realistic? I would emphasize choosing your surgeon and not the approach. I would not recommend pushing your surgeon to use one specific approach or another. I think there may be increased associated complications. Adductors refer to a group of muscles that insert into the medial (inner) upper femur and often become contracted with an arthritic hip. In my experience the approach used to replace a hip does not effect how quickly a patient recovers. Should I go for this or should I opt for the mini posterior. There arent any activities that you can do with a resurfaced hip that you cant do with a total hip. Considering I had no idea about differences between the two approaches, I said OK and surgery did go well and I was back on my feet in no time. Also, only a small percent of C-on-C bearings are being implanted at this time. My doctor does the Posterior approach, he didnt say anything about the mini part. Even after the procedure is completed and the patient is on pain medications, pain and discomfort may occur in some cases. If you refuse cookies we will remove all set cookies in our domain. So im going back to the surgeon that did my left hip and left me in agonizing pain for 2 months after procedure. After the direct anterior approach, there is generally no hip precautions required, and motion is not restricted. daniel neeleman net worth . 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. I have done everything I can think of to preserve my right hip, but sadly this too needs replacing. J Orthop Surg Res. Currently we use standard ways, called either posterior or direct lateral approach. Clearly, yours was. A hip replacement can greatly reduce the pain associated with arthritis of the hip, with almost all patients having complete or near-complete relief. The hip replacement needs to correct the abnormal hip mechanics that lead to the arthritis. http://holycrossleonecenter.com/blog/hip-resurfacing-or-total-hip-replacement-a-candid-discussion/, http://holycrossleonecenter.com/blog/metal-on-metal-hip-replacements/, I wish you the very best recovery. The vast majority of my patients return to work one to three weeks post-operatively. General comments will be answered in as timely a manner as possible. 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.) 2021 May 20;16(1):324 . I would look for a surgeon who is busy, has a strong track record and who practices at a hospital with a stellar reputation and where many joint replacement surgeries are done. In my experience, people recover from femoral nerve injures more frequently and completely than from sciatic nerve injuries. Note that blocking some types of cookies may impact your experience on our websites and the services we are able to offer. An anterior hip replacement does not have any limitations based on comfort. Fortunately, you have already experienced a THR and have done well. By far the most important variable is the doctor who is doing your surgery and managing your post-op care. If your surgeon did a great job, that is something to respect. The most common total hip replacement method is the anterior approach, which allows the surgeon to see better, more precisely place implants, and perform less invasive total hip replacement surgeries. Thanks. In my experience, most patients who undergo a total hip replacement dont limp after their surgery and most feel their legs are the same length. Thru X-rays Ive been told both hips are bone on bone! You can check these in your browser security settings. The pain I get is in the groin and a sharp pain in the buttocks, that feels like muscle pain. Finally, many people who are struggling with hip disease experience lower back pain or even sciatic discomfort. Its been six months since surgery, my operating doctor keeps feeding me with lets wait another month stuff. There is some concern that this weakens the abductor and leads to a limp. I have read your articles about procedures (anterior vs posterior). 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. Regardless, the overall incidence of dislocation for every approach is smaller due to use of larger femoral heads and enhanced closure techniques. But I feel that time could be lost and all my symptoms may become irreversible. Because the femur is more difficult to expose during the anterior approach vs. the posterior approach, many surgeons will select a shorter femoral component to facilitate reconstruction and lessen chance of fracture. As for doctors, the surgeon I had came highly recommended. There is also a small risk of infection at the surgical site. If possible, choose a hospital that specializes in joint replacement and can back that up with excellent statistics and reputation. Adults of any age can be considered for a hip replacement, although most are done on people between the ages of 60 and 80. 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. A hip replacement is the most common cause of complication in about 20% of cases. We provide the best cash prices and customer care in the industry. Also, I am diabetic and have had two organ transplants and am extremely worried about infections, etc. A mini posterior approach is a modification of the classical posterior approach. Back to work/driving in 10 days. If I think you may be a candidate, I will refer you to a doctor in our area that does. Can you suggest any pain medication that would not interfere with anti rejection drugs? 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. 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. This does not necessarily mean they will have more pain or take longer to get well. Occasionally this even requires making a second, separate incision. Ill know a lot more after we meet and I review your X-rays. #1. Here is his perspective based on careful observation of outcomes. 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). It is also important to avoid any sudden movements or twisting motions. I had good results into 5th month post op and then everything went downhill. DAA and SuperPATH were equal in functional outcome and acetabular cup positioning. That being said, you should have the additional surgery where you feel you will have the best chance of doing well. 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. There are a few disadvantages to hip replacement surgery. However, there are also some potential drawbacks to this type of surgery including a longer surgery time, a greater risk of blood loss, and a higher risk of nerve injury. Every . I did have numerous blood tests, MRI of knee and hip, total body scan with radio active injection, X-ray knee and hip etc. Kenneth, You saw me in your office yesterday (I am 48 years old) as I had complications following a THR of right hip anterior approach with revision 4 days later for a slipped acetabular and then last week I had a dislocated hip. I saw a hip surgeon last year for an opinion, but because I had almost no arthritis on the x-ray he said he saw no need for surgery. My recommendation is for you to discuss this with your surgeon if you have further concerns. What is the best stem and ball/socket combo to use for someone that ones to play tennis? I had a consult with a surgeon who does posterior and cuts muscle & tendons. Woke up with My two questions are: 1. Stay was 2.5 days. Often, as the labrum is torn, it leads to a lifting off of hyaline articular cartilage where these two tissues meet, called delamination. Following anterior hip replacement surgery, avoid soaking in hot tub, sauna, or swimming pool immediately after surgery. (PATH) and Supercapsular percutaneously assisted total hip (SuperPATH) arthroplasty: learning curves and early outcomes. Each surgeon approaches these issues individually. Read our editorial policy. This approach has a number of potential advantages, including a shorter hospital stay, less pain, and a quicker recovery. Mini posterior refers to the approach or tissue interval the surgeon uses to implant the Total Hip. After reading your articles, I have decided not to have anterior. The mini-posterior is considered a more straightforward approach then the anterior, resulting in lesser complication rates. I weigh 185 and am 54 and realize its ideal to lose weight prior to surgery (working on it as always). Welcome to Brandon Orthopedics! Would not make eye contact. The SUPERPATH hip replacement is a new technique using superior capsulotomy that allows for implantation of the total hip components under direct vision through a single incision. I am thoroughly confused at this point. He also used the term anterolateral. The most important decision you must make is choosing your surgeon. The majority of teaching institutions in the United States continue to instruct as well as perform the traditional posterior as their primary approach. Hi Frances, did you have surgery posterior Superpath? Risks associated with hip replacement surgery can include: Blood clots. July played my last match when I buckled. The questions youre asking are 100 percent appropriate. My recommendation is to go back to your surgeon and share your concerns and issues to see if a fresh and thorough reevaluation wont help define the problem(s) and solutions. We may request cookies to be set on your device. Sometimes during surgery it is necessary to release particularly tight structures to expose the joint for reconstruction or to better balance surrounding soft tissues after reconstruction. 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. I would encourage you to discuss your concerns with you surgeon. Dr. Parsons has extensive experience in the posterior, anterior and superior (SuperPATH) approach to total hip replacement having performed hundreds of each. In Dr. Lawrence Dorrs opinion, doctors and hospitals should not market a specific type of surgery as the most effective. Imagine your femoral head lacking full acetabular coverage, resulting in an overloading of the superior aspect of your socket, hence the cartilage and labrum becoming damaged and ultimately breaking down. What has changed the most in my career, once again in a very positive way, is how quickly patients start walking (day of surgery), and go home and return to their active lives after THR, as compared with just a few years ago. Fortunately, many folks who experience back symptoms before THR report improvement or resolution after. Hip replacement surgeries are becoming increasingly popular due to their numerous benefits, such as increased range of motion, reduced pain and disability, improved mobility during pregnancy, and improved quality of life. Lazaru P, Marintschev I. 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. This site uses cookies. 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. All: It is not a substitute for excellent surgery. I do not have dials and no one seems to know where the neuropathy stems from. A femoral nerve injury is devastating and is more vulnerable during an anterior approach than with other approaches.
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