Hip replacement via SuperPATH approach had a longer operation time than hip replacement via conventional approaches. I believe going home is very therapeutic and often safer. Click on the different category headings to find out more. You should feel good that you are aware of your fears and that it hasnt paralyzed you into not acting. I was out of bed walking around the evening of the surgery . She provided all kinds of benefits with this approach, as faster recovery, less motion restrictions et.al. 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. SuperPath experiences good or bad | Hip Replacement - Patient I have/had arthritis in my hips. Many manufacturers are responding to the surgeons desire for shorter stems and many are now available on the market. Choose your surgeon and not the approach or prosthesis. I think the recovery time is the same though. Do you have any advice or ballroom dancer THR stories to share? Upgrade to Patient Pro Medical Professional? A number of patients who have undergone this procedure are able to walk unassisted the day after surgery . Some other methods are effective, but they are less effective for patients who leave the hospital earlier. Dr. William Leone. 3 years ago, We have an appointment today to discuss the plan of action. Two which are receiving the most attention are the traditional posterior approach and the direct anterior approach. Does it really not matter which approach I have, posterior or anterior? My advice would be to avoid the extremes of any motion that exceed your hips ROM. 1. A metal or plastic implant is used to replace a damaged or diseased hipbone. Remember, what youre hoping to do is have a hip construct that will last 20 years or more. I would rather see my patients go home. What is SuperPath Hip Replacement? I think it perfectly ok to discuss different approaches and ask for an opinion. The posterior approach is used by a small percentage of people. but it was more torn than they thought and they had to cut out about 1/4 of it. The best of luck to you, I really appreciate this website. This does expose the patient to more radiation but can help with component positioning and sizing. As noted above, because the femur is difficult to visualize, component positioning, sizing, and stability are more likely to be compromised. Brian Tinsley. It will help desensitize and help get your muscles working in synchrony. I deal with OA lower back mess so know I see most likely how all this has played into the surgery. I had the posterior approach, the surgeon did not cut any muscle plus I had no pain at all after the op. Its reasonable to inquire about his or her experience using the Mako robot. I already have an artificial knee that is doing great. Dr. Back to work/driving in 10 days. I encourage you to do the same. I had an anterior right hip replacement in late 2010, I was 72. Hi, Usually a hip problem is addressed before a knee or foot problem because by solving the hip problem first, the knee or foot often improves if the pain is referred from the hip (more common with knee pain) or if by addressing the hip, the body mechanics and the fluidity of gait improve. 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. Dear Doctor Leone, I dont think one surgical approach is better or worse than the other for you to accomplish this. If so, how long until I can get back to normal living? Try our Symptom Checker Got any other symptoms? As of 2020 only Dr. Leone is using the latest hip technique called the SPAIREtechnique where patients no longer have hip precautions after surgery. Select a surgeon based on your impression of that individual: how engaged was he or she in your care, will you have access to that person as well as his or her team before and after surgery? 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. I went with a total hip replacement. I dont know if this stems from the knee surgery but I do not believe so because I was well for about a year and a half. Hello Dr. Patients can also have as little as a 3-inch incision. Doc, Ive worked out and been physically active forever running, biking, skating, etc. Since then, SuperPATH has enjoyed excellent success. It allows the surgeon to work between the muscles and tendons without removing them from their anchoring points on the hip or thighbone. Are my findings that posterior approach in my situation would have been more appropriate? 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. It's a hip replacement surgery where you lie on your side. When done well, your body does well with this technology. 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. I'm hoping to read some posts post surgery. Posted 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. Use of the forums is subject to our Terms of Use There are a few disadvantages to hip replacement surgery. Your out-of-pocket costs for your hipreplacement will be impacted by a number of . In my experience the approach used to replace a hip does not effect how quickly a patient recovers. I just want to thank you for the information on this site. What are your thoughts with regard to Stem cell therapy in lieu of THR? Other jobs, which tend to be more structured and / or more physical, may require more time off. Do I have a high percentage of hip dislocation after a 2nd revision done posterior way if so what is my chance of another hip dislocation even if I do the surgery again? I very rarely transfuse any patients now. It's what compelled me to seek out different methods and post here.. You will find the surgeons will all give the pros but never the cons what ever the method. 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 knee and foot and ankle are messed up too since leg ended up at least 3/4 shorter.I wear a shoe lift, but probably needed it sooner than I realized the shorter issue, My knee is pretty stiff and pain when I walk too much, but I deal with it, it bends good, I sleep good, no pain when I do nothing, so Im working all to do NO knee surgery, This hip was ENOUGH to last a lifetime.. Im 76 and use a lot of supplements to save knee and OA in general..I am looking at other protocols for the knee too.not insurance covered, what else is new.if its good, its out of pocket. Until now. If it is from intra-articular hip pathology such as osteoarthritis, which is very common especially in your age group, then most likely stem cell injections will not be affective and you would benefit from a total hip replacement. Brandon Callahan, MD is a board-certified orthopedic physician with a decade of experience in providing comprehensive orthopedic care to patients with musculoskeletal injuries and disorders. A major muscle is not cut during anterior hip replacement surgery, so pain is reduced and major muscles are not cut after the operation. 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. I have been in pain for about a year and first though it was a back issue and it has limited my ability to stay as active as I would like. 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. Also if the mini posterior approach is so effective when would it not be preferred over the regular posterior approach? Currently, the incidence of dislocation after the posterior approach has been greatly reduced due to technique and other refinements. Often in this group of patients, their X-rays show only minimal cartilage space compromise (it may appear thinned and irregular) and I observe at time of surgery that the labrum appears hypertrophied (to compensate for lack of head coverage) and often torn. Infection: You are given IV antibiotics before and after surgery. There are many effective approaches and techniques that allow implantation of a total hip. bible teaching churches near me. My surgeon has told me I will need PT 3 times a week for 6-12 weeks is this too long? Both problems are on the right side of my body. Please be aware that this might heavily reduce the functionality and appearance of our site. After reading your blog Im thankful he suggested this approach. Disadvantages of the anterior approach include: Although I am trained in both approaches and have trained surgeons in both approaches, I have stopped using the anterior approach because I saw my patients get well faster, bleed less, and have a more predictable result when I performed the surgery using a mini-posterior approach. An anterior hip replacement procedure, on the other hand, performs the same function as an anterior hip replacement in terms of tissue shaving. My physical life is diminished. 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. Hip replacement surgery & recovery time | TRIA Orthopedics - HealthPartners Egton Medical Information Systems Limited. Hip anatomy I wish you the best of luck, Prior to surgery, you need to be evaluated by your primary care doctor and any other specialist who helps manage your care, so the conditions you have can be optimized. Additionally, there is a small risk of dislocation after surgery, which can be painful and may require additional surgery to correct. 2. In 2010, more than 310,000 hip replacements were performed in the United States. A hip replacement can greatly reduce the pain associated with arthritis of the hip, with almost all patients having complete or near-complete relief. I do not do hip arthroscopy. My surgeon does the SuperPath method. The mini-posterior is considered a more straightforward approach then the anterior, resulting in lesser complication rates. Im not sure why you developed a problem with your IT band. Some surgeons will use 2 incisions, both the anterior and superior approach. It is important that you find a doctor who is experienced in caring for people with complex issues. I have a tilted sacrum, sway back and a very large posterior. A typical recovery time from anterior hip surgery is six months. This most often leaves the patient with an area of decreased or uncomfortable sensation or numbness over the anterolateral thigh (top, outside area of the thigh), not the entire thigh. Walking is the best exercise. But this blog was a nice nudge toward the posterior. I think speaking to a patient with whom you can relate and who has been treated by the physician youre considering also is invaluable. Inpatient footage of the patient compilation has been edited out to accommodate hospital rules. July 2013 my left hip was scoped for a labral repair. One advantage the ceramic-on-polyethylene carries is the lack of . Thank you. I wish you well. There are risks and recovery times associated with surgery. I am female and I weigh 115 pounds. Many of these stems have very little if any long term follow-up, although some appear to be doing well in the short term. Hello Dr Leone, I ask my patients to restrict certain positions that exceed the mechanical limits of the artificial hip for the first six weeks. I understand and respect that many surgeons prefer doing them simultaneously. 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. You should not proceed unless you know in your heart that you will be taken care of in a manner that has the best chance of giving you as perfect a result as possible. 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. Results of the surgery numbness in the right thigh, inability to stand on the right leg, muscle atrophy all confirmed by EMG and second orthopedic surgeon. The highly crossed linked polyethylene liners are now the gold standard in this country. What you can do is keep as good an attitude as possible and keep rehabilitating your leg. 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. It is important to consider the SuperpathTM technique if you are considering a hip replacement. Nerve regeneration can occur up to 18 months following injury, but the chance of full recovery decreases with delay in recovery time. The incision made for the operation can be as small as three inches. I have seen a number of patients who were reconstructed with the anterior approach who developed painful anterior scarring after the procedure. If possible, speak with other health professionals who work at the hospital or at least in the same geographical area. Complications associated with an anterior approach hip replacement are similar to those associated with standard hip replacement surgeries. J. Dear Dr. Leone, I understand that most surgeons now do a spinal rather than general anesthesia. With SuperPath, there is no surgical dislocation of the hip. The first surgeon never mentioned this condition at all. When the anterior approach is used, the soft tissues in the hip stay intact, allowing for better hip alignment. Pain and disability are reduced. If I have a 2nd revision of my right hip is it posterior approach or the mini-posterior approach as you discuss above? I try not to bring up my mess but its hard when its with one 24/7. Does my prothesis not last as long since I am now doing a 3rd surgery? The majority of teaching institutions in the United States continue to instruct as well as perform the traditional posterior as their primary approach. 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. My husband, who is only 35, has to consider a THA in the near future and Im very torn over which approach as the surgeon we really like dos a posterior but I am concerned about dislocation rates in posterior vs anterior. 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. Because my husband has circulation problems in his leg and vein removed for open heart surgery last yearhis surgeon recommended the Mini posterior surgery. Thank you for sharing with others the nerve supplements that youre finding affective. Only Dr. Leone will be using the most recent hip technique known as the SPAIRE technique as of 2020. Very strange Is THR something that can help? That I knew this recovery may take 1-2 This too will lower your anxiety and improve your experience. 4 mts later am using Will I still be able to do the things I like to do? Most of the restrictions are removed at that time, although I still advise common sense, particularly for the first three or four months. Over the years, these precautions and the length of time to adhere to these limits have been challenged both by clinicians and patients. 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. Hard-on-hard bearings, such as ceramic-on-ceramic as well as metalon-metal articulations, also resulted in larger femoral heads being implanted. Also, when a single joint is replaced versus bilateral, there is significantly less bleeding and hence a much decreased need for transfusion. 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 also think infection must be investigated and ruled out. Both have valid cons against the others methods and pros on their method. Over time, some patients may acquire sensitivity or an allergy to the metal particles produced by the metal ball and socket. I prefer reconstructing the most symptomatic side first. Does this mean my body may reject the metal of the post or cup? I, too, am struggling which approach to have. A couple of things I am hoping you will explain using laymans termology. 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. Remain upright . I am a South African and need to make a decision on whether my mother (69) goes for an AMIS or traditional posterior. We provide you with a list of stored cookies on your computer in our domain so you can check what we stored. I am a!so told by the orthopedist who referred me that I need arthroscope on my right hip. The main limitation after surgery is a lack of comfort. For centers like Phoenix Spine and Joint that use a robot, there is . SuperPath hip replacement is a differentiated total hip technique being performed by a growing number of experienced surgeons. It is critical to consider the pros and cons of each option before making a decision. How Much Does Minimally Invasive And Robotic Hip Replacement Surgery Potentially there also is less pain and a quicker recovery. The new prosthetic socket must be medialized (placed further toward the midline) and sometimes through the medial wall of the native socket. Also, only a small percent of C-on-C bearings are being implanted at this time. Always speak to your doctor before acting and in cases of emergency seek I would consider talking to other patients who had their hips replaced by that physician and learn about their experiences. 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. Because the patient is lying on his back during the procedure, fluoroscopy or moving x-rays are used to aid in the examination. Every . In my experience, people recover from femoral nerve injures more frequently and completely than from sciatic nerve injuries. Hip replacement - Wikipedia Patient Concerns Share your concerns with your surgeon. I would research and find the physician and hospital that will give you the best chance of doing well. Fewer narcotic medications are administered, resulting in a better overall recovery. Should one of these events occur during a mini-posterior procedure, they are easier to recognize and correct. Have you recovered by now? Also, the surgeon said that I would end up having one leg shorter than the other is this true? That being said, if the foot is now a much bigger problem than the hip, you may have to deal with that first. I would also like to know about the customized implant, as I havent yet heard much about it. I dont think there is one best prosthetic. Some have features that are more suited to one persons anatomy and needs than others. An anterior approach hip replacement is one of the most minimally invasive surgical options for replacing a hip. Being discharged to a rehab unit is now the exception. Rather, they say Bill, please just do what you have to do and do a great job. Im an avid skier and just found out I did not have full Anterior but rather AL. I think tennis, dancing and horseback riding are fine. Patients mobilize the day of surgery and typically go home the next day. All have advantages and disadvantages. Length of hospital stay with SuperPath hip replacement approach. Dear Dr. Leone, As a result, you are unable to pick up something from the floor or bend down to tie your shoes. In a very positive way, surgical techniques for both anterior and posterior approaches have evolved wonderfully since your surgery was done 10 years ago. On the other hand, there may be a slightly increased incidence of anterior instability. Three Cons of Hip Replacement Although total hip replacement is deemed a very safe procedure, there are associated risks that patients need to be made aware of before surgery. There is some concern that this weakens the abductor and leads to a limp. There are a few complications that can occur with anterior hip replacement surgery. THR - Posterior or Superpath Decision - Joint Replacement Patient Forum I am a sixty five year old active male and need THR on my right hip. My advice is to have a frank discussion with your surgeon and share these concerns. Dr. Leone, I am coming in to see you for an appointment for a THR to my left hip. 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. Ten years ago I had total hip replacement on the left at hss. The vast majority of my patients return to work one to three weeks post-operatively. I am now 59, still in good condition but that is being compromised by lack of working out as my hips get sore from most everything I try. If, on the other hand, the leg length difference is creating hardship and possibly discomfort in other joints such as the lower back, knee or ankle, I would consider proceeding with contralateral THR sooner rather than later. I have done everything I can think of to preserve my right hip, but sadly this too needs replacing. What Ive seen in my practice is that the more total hips I do, the less restrictions I place on my patients and the more active my patients are. Its also reasonable to ask to speak to other patients who have undergone THR using this technique to learn about their experiences and results. I am about 5 6 and 185 lbs, age 58, he did not think the weight was an issues. I have seen 4 surgeons. Diagnosed possible labral tear. Does anyone ever attempt to do both at the same time if THR is determined? I find it curious that you report having a good result for the first five months after your surgery as this suggests that the surgery was done for the right indication, i.e., you did well and were pleased for the first five months after THR. Typically, most are eager to go home the very next day; many have already progressed to a cane, which they will not use very long. I wish you luck on your journey. Woke up with Finally, many people who are struggling with hip disease experience lower back pain or even sciatic discomfort. There is also a small risk of death associated with any surgery. A ball and socket are used to connect the new joint to the thigh bone (femoral bone), which is made of metal, plastic, and ceramic. William Leone. These positions include crossing your legs, bending your hip more than 90 degrees, or lying on your stomach. Patients who work for themselves are very motivated to return to work and often do so between procedures. About my surgery: I had to wait 30 hours before surgery, two days later I was released, within two more days I stopped using my walker. Hip replacement surgery can open up a world of possibilities for people who have lived with pain and restricted movement. My surgeon uses the posterior approach. Dear Dr. Leone, I am having Makoplasty ( robotic imaging) to my right hip in February. Not only was my recovery twice as fast with the anterior, there was very little pain in comparison. Should I go for this or should I opt for the mini posterior. Thank you, Rita. What is SuperPath hip replacement? This suggests that something changed after five months. What determines the differences? In general, if someone is dedicated to the job, the return is very quick. 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. disadvantages of superpath hip replacement Surgical Approaches To Hip Joint Dr. Apoorv Jain D'Ortho, DNB Ortho . 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. The size of the incision is determined by how large and tight the hip/thigh is and how much tissue (fat and muscle) exists between the bones of the hip and the overlying skin. Hip replacements might keep you out of action for a considerable period. I weigh 185 and am 54 and realize its ideal to lose weight prior to surgery (working on it as always). There is no definitive answer to this question as different people will have different opinions and preferences. Unfortunately, injury to the lateral femoral cutaneous nerve is a common complication after the anterior approach for hip replacement. Total hip replacement is one of the most successful operations ever developed and is a remarkably predictable way to relieve pain from arthritic conditions. 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. Either and all body types lend themselves to the posterior approach because it is more extensile (can make it bigger and release more soft tissue structure if needed). I would avoid the metal-on-metal articulation. Also there are concerns about disruption of blood supply to femoral head with this operation. The surgical "approach" in total hip replacement describes the anatomical pathway and technique that the surgeon uses to access the hip joint to perform the surgery. Really Great. United States. More soft tissue trauma can result do to this increased difficulty in exposure and then gaining more exposure if necessary. I believe a THR will benefit you tremendously. I am 5 weeks out and have been doing beautifully! No groin pain NOW.but all the other mess of it all. It is nice to see honest Q&A versus a marketing page. By far the most important variable is the doctor who is doing your surgery and managing your post-op care. In my practice, patients who undergo a THR using a mini posterior or posterior approach: 1. Publications I believe this is an important discussion you should have with your surgeon preoperatively. It sounds like he did fabulous job. The doctor used the posterior procedure. With that said, I would have probably just done the posterior with you if we lived in the US based exclusively on the time you take to respond! I take care of many individuals who have a total knee and hip replacements on the same side. Seeing that a THR is considered major surgery, my question is, should I have my left hip done sooner than later to address the length difference or wait until I can no longer tolerate the pain? Just getting your thoughts I will discuss it more with my surgeon at the pre-op meeting. 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. It is critical that the patient is aware of the risks, benefits, and alternatives of the procedure. Being cared for in a hospital that specializes in joint replacement and has an extensive specialty medical staff also is key. We are now in a situation where we have found two extremely good surgeons and we gel with both extremely well. I saw a surgeon who does the posterior approach only and will see another on 4/14/15 who does both approaches. Original Medicare (Part A and Part B) will typically cover hip replacement surgery if it's medically necessary. So im going back to the surgeon that did my left hip and left me in agonizing pain for 2 months after procedure. I am now bracing myself for THR surgery within the next year and am wondering if there is any big advantage in trying to have this done by a surgeon who offers the customised implant, as above. This does not necessarily mean they will have more pain or take longer to get well. My personal preference has changed from doing both hips during a single anesthetic to staged procedures two to three weeks apart. SuperPath Tissue Sparing Hip Approach | MicroPort Orthopedics Click to enable/disable _gid - Google Analytics Cookie. Both of these are very successful ways of doing a hip replacement. Not sure exactly what that means. Felt very uninformed and left 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.
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