I was released to go back to work after only 10 days. The development of a complete and secure surrounding scar tissue wall or pseudo capsule is critical for stability. This is not true for bilateral cases. 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. There is also a small risk of death associated with any surgery. I assume PTHR is referring to partial hip replacement. The surgical area of anterior hip replacement is located in the vicinity of the lateral cutaneous femoral nerve. 2004 Apr. This surgical procedure is performed with a patient lying on their side, and a surgical incision made along the outside of the hip. What do you consider to be the most important factors in choosing a surgeon? About this injury to me. Lift your knee rather than your hip at the same time. Click to enable/disable _gat_* - Google Analytics Cookie. It is important to consider the SuperpathTM technique if you are considering a hip replacement. Third, the procedure is shorter in length and requires less hospital stay than traditional hip replacement surgery. 10 users are following. Intervals between muscles are separated or muscles are separated in line with their fibers without injuring the muscles innervation. If not, what will my restrictions be? Since a significant amount labrum has been removed, I think another attempt at arthroscopy would prove very disappointing and I would not recommend it. The femoral prosthesis is inserted into the hollow part of the femoral shaft. In 2013 I had a THA done on the left hip. Fort Lauderdale, FL 33334 Additionally, people with certain health conditions such as diabetes or heart disease may also not be good candidates. J Bone Joint Surg Am. Because these cookies are strictly necessary to deliver the website, refusing them will have impact how our site functions. Both of these are very successful ways of doing a hip replacement. He is passionate about helping his patients achieve the best possible outcome and is committed to providing the highest quality of care. A typical recovery time from anterior hip surgery is six months. I would focus on the individual doctor, not the approach that the individual choses to use, to deliver the best result. Hip Surgery Techniques - Hip and Knee My second question relates to something you mentioned earlier regarding checking the published track record of the surgical team if I use an HMO, how do I find that information, and how do I know it hasnt been skewed to give more favorable results (lying with statistics)? Some surgeons believe that a patient who is neither obese nor overly muscular is a good candidate for anterior hip replacement surgery. 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. Not sure exactly what that means. Following the anterior approach, we provide you with a number of precautions and positions that you should avoid if you are in danger of being discomfited. Why is that? Finally, I would choose a doctor with whom you connect and whose staff is engaged and knowledgeable. The intended interval between the front thigh muscles can be difficult to recognize and there has been an associated increase in injury to the femoral nerve or vessels. These parts have a porous coating that the bone grows into. Does my prothesis not last as long since I am now doing a 3rd surgery? Each question is scored from 1-5, with 1 being no problems and 5 being severe problems. 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. Being cared for in a hospital that specializes in joint replacement and has an extensive specialty medical staff also is key. There are a number of different potential surgical approaches available for hip replacement, each with their own potential advantages and potential drawbacks. If its a struggle, then the situation needs to be reassessed. The highly crossed linked polyethylene liners are now the gold standard in this country. Any feedback will be appreciated. Testimonials I am an obese female and will be 62 in February. I have seen 2 doctors one doing posterior, the other anterior. Everyone I know that has had both posterior and anterior surgery say not to even consider posterior. SuperPath experiences good or bad | Hip Replacement - Patient My hope is that some of these symptoms will improve with time. 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. Adductors refer to a group of muscles that insert into the medial (inner) upper femur and often become contracted with an arthritic hip. I think cutting muscle was in the past. Almost all bilateral THR or TKR patients go to a rehabilitation facility after their acute stay, not home. I wish your patient well. I had an anterior approach hip replacement. THR - Posterior or Superpath Decision - Joint Replacement Patient Forum My question is, I am a very active 67 yr old. Since my acetabulum is too shallow, and other angles are off as well, how does the new cup get positioned correctly? I think its vitally important that you go into surgery truly believing in your heart that you are going to do well, and that you are with the best surgeon and team who will help you. Because of this, when you're ready to get up and walk about again, engaging your muscles and hip flexors might be extremely tough. The Hanna bed, general anesthesia machines, spinal setup, medications, ventilation, instruments, and their sterilization are all prerequisite. Most receive a simple spinal with sedation. I feel that at 10 weeks with profuse denervation potentials on the quad muscles, the prognosis is not good, even at 6 months. How long will my hip replacement last? Finally, many people who are struggling with hip disease experience lower back pain or even sciatic discomfort. If your surgeon cant answer your questions about hip replacement or provides unsatisfactory answers, you may need to consult another surgeon. Lastly, if one has had P or AL is there anything that can be done to offset the need for restricitons? I had posterior and much like the superpath trussed into the jig . . Because of the marked improvement in modern plastics, there is greater longevity and durability of acetabular plastic liners and larger femoral heads are used routinely which results in an improved the head/neck ratio and therefore the jumping distance for a hip to dislocate. This allows you to resume normal daily activities quickly while also returning to normal range of motion and function. 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). Ultimately, you and your husband need to choose the surgeon who you both feel will provide the possible best care, based on reputation and your personal comfort level. 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. 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. There are a few disadvantages to hip replacement surgery. Most THR patients do not need significant supervised physical therapy after surgery; they simply do well when their surgery is done well. DAA had a lower rate of hospitalization and functional rehabilitation as compared to the lateral approach, as well as a lower perceived level of pain. An anterior hip replacement is not covered by a specific credential system for orthopedic surgeons. I believe choosing your physician is the most important decision you can make. That being said, you should have the additional surgery where you feel you will have the best chance of doing well. The information I have gathered seems to indicate the anterior approach is more inherently stable, making precautions unnecessary. Very few metal-on-metal bearings are being placed today due to the serious potential of metallosis. 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. Ive never foulnd information from any doctor or research-site but that there is always no legs-crossing, no more than 90-degrees (for the most part), and no twisting for anything but full Anterior. Surgical Approach Types | Hip Replacement | Elvis Grandic, MD 4. This complete wall of tissue that surrounds the new hip imparts stability. Our team of experts, doctors, and orthopedic specialists are here to share their knowledge and experience with you in order to help you make informed decisions about your health and well-being. Thanks for any feedback. How Much Does Minimally Invasive And Robotic Hip Replacement Surgery Also if the mini posterior approach is so effective when would it not be preferred over the regular posterior approach? My acyive 60 year old husband is scheduled to have Mini posterior total hip replacement in 6 weeks. Does anyone ever attempt to do both at the same time if THR is determined? Do you also do arthroscope surgery? Of note, I am a RN with 30 years of experience and took this decision very seriously. Thank you for sharing. Advantages of an anterior approach to hip replacement A major muscle is not cut during the anterior procedure. I am concerned that I may have a pinched nerve and that that is what is causing all this pai as the pain is severe only in certain positions but when I am tired I also have a throbbing pain in the sciatic region.talk about the golden yearsI thank you from the bottom of my heart for the kindness and caring that you do in answering all these questions. I again suggest you concentrate on finding a surgeon in whom you have faith and then trust that doctor. My mom is obese, short and has osteoporosis. An operating room that can support safe Anterior or SuperPATH minimally invasive joint replacement surgery costs around $1.5 million. When the stem is placed in the femur, it still destroys the same amount of bone for implantation, regardless of which approach is used. 5 Things to Know About Anterior vs Posterior Hip Replacement 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. I walk a lot in my job and bend lots (work with children) and sitting causes pain due to impingement. There are hybrids of the surgey from what I can see. Fortunately you live in a part of the world where there are many capable orthopedic surgeons. SuperPath hip replacement is a differentiated total hip technique being performed by a growing number of experienced surgeons. 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! I believe going home is very therapeutic and often safer. It was discovered that I had a torn Labrum.