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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. bible teaching churches near me. Thank you, Lisa Blumthal. I am unsure whether the minimal invasive posterior is available in SA. Infection. Historically in my practice I performed many Bilateral THR and TKR and have backed away from that practice. Due to security reasons we are not able to show or modify cookies from other domains. Also, in the U.S., nearly all stems which are being implanted through the anterior approach are press-fit rather than cemented. If this occurs, the patient may experience pain and swelling. The doc I saw yesterday said 4 weeks. I live in Staten Island and need rt hip replacement. 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). My worry is that I will end up with one leg shorter than the other. I wish you the very best, I'm so encouraged to hear your successful story. I then stage the second surgery as early as 2 or 3 weeks post-operatively. I had an anterior right hip replacement in late 2010, I was 72. I should think that all your expectations are appropriate for the activities you look forward to, especially considering youve already done so well after your knee replacement. Posterior or Anterior? Recovery time for anterior hip replacement is typically two to four months, and recovery time for posterior hip replacement is typically four to eight weeks. i had lateral posterior, my surgeon stopped doing anterior because he said it caused muscle problems moving them about and can also cause nerve damage, which is the main reason I did not want that approach. You are to be commended for taking the time to answer our questions. We provide you with a list of stored cookies on your computer in our domain so you can check what we stored. I have been doing ALOT of research about the different approaches to THR and looking for the absolute best surgeon. I read hip dislocation is 28% higher after a revision, is it more then 28% after 2 revisions??? Complications from infection account for approximately 10% of all cases. but it was more torn than they thought and they had to cut out about 1/4 of it. As of 2020 only Dr. Leone is using the latest hip technique called the SPAIREtechnique where patients no longer have hip precautions after surgery. Some of the most common considerations are age, weight, activity level, and the presence of other health conditions. What is your experience and take on this ? People undergoing traditional hip replacement surgery, for example, are advised not to bend at the hip more than 90 degrees for approximately six weeks after the procedure. I still have a very big limp and still undergoing physical therapy. 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. What, if anything, can be done to revive femoral nerve and get my thigh muscles back in normal? Dr. William Leone. Fortunately, if the components are stable (bone-in grown or cemented) and optimally positioned, and the surrounding tissues has fully healed and matured, then that risk is very small. Ceramic-on-polyethylene is currently the most popular hip replacement material, representing 50.6% of all hip replacement cases back in 2014. THR if a MRI or Pet Scan isnt done? Call (919) 781-5600 to find out if you need total shoulder replacement in Raleigh, Cary, North Raleigh, Garner, or Holly Springs. I had the mini posterior approach done and it gets better everyday. Patient does not provide medical advice, diagnosis or treatment. If you do not have a hip replacement, you will live a sedentary lifestyle and become overweight. The surgeon makes 2 incisions one bigger than the other on the rear side and separates the muscle and tendon to get to the hip instead of cutting the muscle and tendons to get to the hip. Always speak to your doctor before acting and in cases of emergency seek Does my prothesis not last as long since I am now doing a 3rd surgery? Can you suggest any pain medication that would not interfere with anti rejection drugs? We now have too many other proven bearing surfaces available. 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. Thank you. Ill know a lot more after we meet and I review your X-rays. A number of patients who have undergone this procedure are able to walk unassisted the day after surgery . 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. Others will be empowered when they read and relate to you and/or your experience. Im getting close to needing my left hip done. I know the most important decision you will make is choosing the doctor who will perform your surgery. The hope is that these new designs will, but time will tell. Lateral femoral cutaneous nerve injury is the most common injury incurred during an anterior approach. Thanks so much for your help, very grateful. I understand and respect that many surgeons prefer doing them simultaneously. What surgical approach is typical for a complex total hip replacement? There are a number of different surgical ways (approaches) to access the hip joint. It is nice to see honest Q&A versus a marketing page. To have your other hip replaced through a different approach is a decision you need to make with your surgeon. External rotation of your feet should be limited (avoiding them twisting to the outside as Charlie Chaplin does) and hip hyperextension should be avoided. I needed no physical therapy at all. All of these releases may be necessary as part of the surgery and patients do well. I wish you a full and speedy recovery. The anterior approach has a lower incidence of sciatic nerve injury and a higher incidence of femoral nerve injury. The earlier the recovery begins, the better chance for a more-complete recovery. 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. 2 x week. Mar 13, 2013. Otherwise you will be prompted again when opening a new browser window or new a tab. Last summer I wiped out on my bike and snapped off the top of my right femur, with a diagonal break. You can resume your active lifestyle as soon as possible thanks to a new prosthetic hip. You are free to opt out any time or opt in for other cookies to get a better experience. Hey, thanks for the forum topic.Thanks Again. Since these providers may collect personal data like your IP address we allow you to block them here. Im now 6 weeks out and doing good. I have done everything I can think of to preserve my right hip, but sadly this too needs replacing. Click on the different category headings to find out more. It seems, however, that at this time point, patients who have received resurfacings do as well or better than similar patients who have received total hip replacements. 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. Therapy hopefully will help any contractures and scaring within your muscles that might have developed after surgery. Having physio 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. 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. From what Ive seen, most THR patients dont need very much PT, although I do encourage exercising in a pool. Comments about life-long hip restrictions between Posterior, Anteriorlateral and Anterior approaches? Types of Hip Replacement (Approach) Hip replacements can be preformed through a direct anterior approach, an anterior lateral approach, a lateral approach, a posterior approach, and a superior approach. My question is, what will my restrictions be? SuperPath hip replacement is a differentiated total hip technique being performed by a growing number of experienced surgeons. 3 years ago, Will I still be able to do the things I like to do? Dr. William Leone. Do I have a risk of fractures during a posterior right hip revision due to my prior complications already? In some individuals, it takes much more force and dissection in order to accomplish this (typically, there is significantly more bleeding from an anterior approach compared to a mini-posterior approach). I definitely would not recommend a hip scope and THR during one anesthetic setting. and Privacy Policy and steps will be taken to remove posts identified Tina, which procedure did you have? My problem isnt from a worn-down joint with no cartilage. My main concern is that I have a tilted sacrum and a very sway back. It is critical at time of surgery that an excellent range of motion be created without impingement. 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. However, some offer greater patient benefits than others. Risks associated with hip replacement surgery can include: Blood clots. 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. Years ago, experts assumed that anterior hip replacement had lower rates of hip dislocations and nerve damage than other forms of hip replacement. I had the mini-posterior at MGH hospital. A hip replacement can greatly reduce the pain associated with arthritis of the hip, with almost all patients having complete or near-complete relief. An anterior-approach hip replacement necessitates a small incision in the groin area on the front side of the leg. He is highly respected by the medical and chiropractic community, so i plan to have a appointment to discuss his plans for my surgery. Extensive release of the posterior capsule including . 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. DAA and SuperPATH were equal in functional outcome and acetabular cup positioning. 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. 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? I think the recovery time is the same though. 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? You are here: Home 1 / avia_transparency_logo 2 / News 3 / disadvantages of superpath hip replacement disadvantages of superpath hip replacementtesla floor mats, model y June 7, 2022 / kimt contest page / in are dogs allowed at schoetz park / by / kimt contest page / in are dogs allowed at schoetz park / by Country. I feel good now and walking good now but feel so disabled as I dont know if my hip will dislocate again.I am sorry if you may have responded to some of these questions already as it is so much information to absorb and I dont want to make a wrong decision again. Many of these stems have very little if any long term follow-up, although some appear to be doing well in the short term. With the ease of movements during pregnancy, you will be able to move around more freely. A modern artificial hip joint is designed to last for at least 15 years. 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. I absolutely would not insist on minimally invasive surgery and a small incision, especially considering your mom is short, obese and has osteoporosis. What is most important is that the surgery is expertly done, that the tissues are not brutalized, and that the surgeon can see what he or she is doing. Overall, it sounds as if youve had an excellent result and wonderful recovery following your hip replacement. Thanks. Also available today are larger modular heads, made possible because our plastics are so much better than years prior. Note that blocking some types of cookies may impact your experience on our websites and the services we are able to offer. I think the recovery time is the same though. Posterior hip surgery may be the best option if your surgeon makes a larger incision at the side or back of the hip joint. 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. Following surgery, the surgeon will devise a routine for the patient to engage in that is both comfortable and safe. After reading your article I am concerned about the issues you discussed. Not only was my recovery twice as fast with the anterior, there was very little pain in comparison. for Orthopedic Care Most importantly, I would meet with your surgeon and discuss all of these concerns. My physical life is diminished. Will meet with doctor soon but when I was finally able to really exercise after surgery I overdid it and developed plantar fasciitis. Just getting your thoughts I will discuss it more with my surgeon at the pre-op meeting. I would like your opinion. Having diabetes and two organ transplants does significantly increase your risk for post-op infection as well as other complications. 2023 Brandon Orthopedics | All Right Reserved, hip replacement pain reduction surgery patients, The Best Sneakers For Hip Replacement Patients, Anterior Hip Replacement Surgery: The Pros And Cons, The Truth About Spinal Stenosis: Causes Symptoms And Treatments, Can Years Of Surfing Contribute To Spinal Stenosis, The Effects Of Spinal Stenosis And Carpal Tunnel, Should I Apply Ice Or Heat To A Compression Fracture, How Does A Soft Bed Prevent Healing Of Herniated Disc, Herniated Discs: How To Sleep Without Worrying About Rupturing Your Discs, If You Have A Herniated Disc You Know The Excruciating Pain It Can Cause. If I can put you on the spot. Maybe someday our nations health care system will measure up to that of France, Norway, Switzerland and others, in which their governments are investing half of the GDP that we are wasting. 4 mts later am using Over time, some patients may acquire sensitivity or an allergy to the metal particles produced by the metal ball and socket. Our overall findings suggested that the short-term outcomes of THA through SuperPATH were superior to DAA. Conserves the two main muscles that make up the front of the hip and upper thigh aspirated via the direct anterior approach. It is critical to consider the pros and cons of each option before making a decision. The surgeon accesses the hip joint from the front of the hip, rather than from the back or side. The art of surgery should mimic a well rehearsed ballet or symphony. When done well, your body does well with this technology. Finding the right surgeon is critical, because your care is about so much more than just fixing your hip. Adult patients who have a deteriorated hip may be candidates for total hip replacement. I still have some questions I hope you can answer as this is so distressful for me. 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. Almost all bilateral THR or TKR patients go to a rehabilitation facility after their acute stay, not home. I typically do hip replacement on the get anterior approach in 90% of my patients. We are always refining and trying to make it better. Is it really as good as it sounds? General comments will be answered in as timely a manner as possible. The bigger the ball, the bigger the ROM without impingement and the bigger the jumping distance that would be required for the hip to dislocate. 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. Lastly, where can I find a great surgeon that takes FL Workmans Comp? 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. Every hip implant has benefits and risks. 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. I would emphasize choosing your surgeon and not the approach. If you were in Los Angeles and needed a THR who would you choose to do your surgery? Diagnosed possible labral tear. By continuing to browse the site, you are agreeing to our use of cookies. respect of any healthcare matters. You should feel good that you are aware of your fears and that it hasnt paralyzed you into not acting. Thank you so much for your answer, I appreciate your taking the time to care about others. Its from a malformation. There are many benefits to posterior hip replacement surgery including a quicker return to daily activities, a more natural feeling hip joint, and a decreased risk of dislocation. 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. Since I previously had both knees replaced (by another surgeon) about 5 years ago and still have problems with the knees i.e. Fortunately, you have already experienced a THR and have done well. But Im impressed with your blog and responses, so am writing to ask you about an apparently new procedure in which the surgeon uses a customised implant, utilising pre-operative 3D CT scanning. It's cut off and removed through the hole. The socket of the pelvis is machined into a hemisphere and a metal hemisphere is inserted into the socket. 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. Getting those studies will not change the reality that you will need THRs. Many studies suggest that any limp or clinical weakness resolves after approximately three months. I share your concern that with profuse denervation potentials 10 weeks post injury, that the patient may have sustained a more severe injury than a neuropraxia. I am a South African and need to make a decision on whether my mother (69) goes for an AMIS or traditional posterior. Super path appears to come with it's hazards due to bone sawing rather than dislocation of the hip to be replaced, making revision much more difficult if issues occur later down the line. If I do a single hip or knee replacement, that patient is out of bed standing and, in most cases, walking the afternoon of surgery. I prefer spinal anesthesia when possible because fewer drugs are used and often the experience is gentler. Dr. William Leone, Hello Dr. Welcome to Brandon Orthopedics! If you would like a personal consultation, please contact our office at 954-489-4584 or by email at LeoneCenter@Holy-cross.com. SuperPath hip approach. Dr. Parsons has extensive experience in the posterior, anterior and superior (SuperPATH) approach to total hip replacement having performed hundreds of each. Dear Mary, Although, personally I would feel strongly about reconstructing the hip through the mini posterior approach (there tends to be considerably less bleeding with this approach), other very caring and competent surgeons might feel just as strongly about using a different approach. Celle said: Superpath may give you a faster early recovery, but whatever method is used, recovery is still going to take a long time. Most individuals who have had total hip replacement surgery fall into this category and simply resume their lives.. Posterior, mini posterior or anterior? Can you explain this approach? 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 wish you the best of luck, 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. Please comment. She never though mentioned an increased risk of damaging femoral cutaneous nerve or possible muscle damage that would turn into improperly heeled muscle as a result. There are a few disadvantages to hip replacement surgery. I plan to retire from working full time June 2017 and am concerned about having appropriate insurance after that. Registered number: 10004395 Registered office: Fulford Grange, Micklefield Lane, Rawdon, Leeds, LS19 6BA. There is a more than 200% chance of knee infection, most likely because the knee has more surfaces that can become infected with an infection. I would like your opinion on the stem cell injections as I am really afraid of the second surgery on the same side of my body. It seems that whatever their particular approach is that is what they sell. I wish you a full and satisfactory recovery. 1000 NE 56th Street, Better luck to you all. At the end of the day, I promise, it is not the approach but rather the person who is doing the surgery. 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. I thought the newer procedure on the special table was the best way to go. So im going back to the surgeon that did my left hip and left me in agonizing pain for 2 months after procedure. Sometimes, it simply isnt possible to accomplish. Hi guys im 43 and live in Australia and due to have hip replacement in 7 weeks but im so confused as my surgeon is doing the posterior and im off work for 6 weeks where i here people having the anterior and going back sooner and no restrictions on hospital discharge any advice. Surgical Techniques The vast majority of my patients return to work one to three weeks post-operatively. I would then let that person decide with what approach they think they can best accomplish the surgery and deliver the best result. Also, the choice of femoral stem is more likely to be influenced by the approach and not the persons anatomy and hip mechanics. Choose your surgeon. Low-risk anterior approach patients are those who have significant deformities in their proximal femur as a result of previous trauma or dysplasia, or who have previously suffered from acetabular bone fractures. We are an online blog dedicated to providing comprehensive and accurate information about orthopedics and injury prevention. SuperPath approach is the least invasive due in part to the minimal amount of tissue damage. I have seen a number of patients who were reconstructed with the anterior approach who developed painful anterior scarring after the procedure. Irrespective of the approach that is used to implant the prosthesis, the tissues that surround the new prosthetic hip must heal and mature if the hip is to achieve stability. 2. About how much does this cost? Are these expectations realistic? Fewer narcotic medications are administered, resulting in a better overall recovery. Hi Frances, did you have surgery posterior Superpath? 3. 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. Having a THR is a major undertaking and it is reasonable to expect the hip construct to function optimally for twenty and more years. SuperPath brings some of the best benefits such as; earlier ambulation, no loss of strength, quicker recovery, less pain, decreased dislocation risk, and easier exposure for future revision surgery. Ive done PT and plan to continue working on strengthening my core and flexibility of those large muscles. Because I have scfe also in my left hip, I will have to have it fixed too. How long will my hip replacement last? I recently had a spontaneous hip fx and was diagnosed with hip displasia. 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. I had the posterior approach, the surgeon did not cut any muscle plus I had no pain at all after the op. The posterior approach for hip replacement surgery is by far the most common surgical technique used in the United States and throughout the world. Iliotibial (IT band) damage, had 2 months of ART release work on this issue. I also think its reasonable to look forward to returning to all of the listed activities that you enjoy. In bed for long periods with little or no movement. Hip anatomy With SuperPath, there is no surgical dislocation of the hip. Clearly, yours was. 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. In another day I was able to take short walks without any limping, etc.. Total hip replacement is a step-by-step surgery to replace the hip socket and the ball at the top of the thighbone (femur). If your surgeon cant answer your questions about hip replacement or provides unsatisfactory answers, you may need to consult another surgeon. I advise both my total hip and my total knee patients to avoid repetitive impact activities like distance running.
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