I think they are happier and rehab more quickly. The doc I saw yesterday said 4 weeks. Many others feel the same. Thank you, Lisa. Thank you. 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. Historically, higher dislocation rates were reported with the posterior approach, but it still was used for its many other advantages. I am Australian so no business from me but it has helped me become happier with my prospective surgeons judgement that he will offer me a posterior THR (hopefully the minimally invasive) when my insurance allows the procedure to occur. 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. Thank you for sharing. I'm so encouraged to hear your successful story. Recently the doctor doing anterior decided because of thin bone, he should do direct lateral approach. Some other methods are effective, but they are less effective for patients who leave the hospital earlier. If you refuse cookies we will remove all set cookies in our domain. Full Function, Faster . Clearly, yours was. 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. Can you suggest any pain medication that would not interfere with anti rejection drugs? In the hands of a master, all can produce wonderful and predictable results. Although Superpath hip replacement is often a safe treatment, it may be associated with certain concerns, such as increased postoperative pain, as with any surgical procedure. This absolutely does not require a special table. 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. I think its reasonable to request a tour of the facility where youre considering having the procedure. Every prosthetic joint has a mechanical range of motion. First, I am a little bit scared. I tore my labrum at age 43 and only discovered then that I had bilateral dysplasia. I was out of bed walking around the evening of the surgery . Lastly, if one has had P or AL is there anything that can be done to offset the need for restricitons? Gary. Posterior, mini posterior or anterior? Clearly, he or she has earned your respect and confidence. Does my prothesis not last as long since I am now doing a 3rd surgery? This suggests that something changed after five months. I ask my patients to restrict certain positions that exceed the mechanical limits of the artificial hip for the first six weeks. Further, the extent of dissection is more minimally invasive, which also improves stability. I am temped to wait but it is getting worse. Understand that every total hip, no matter which approach is used to implant it, has the potential to dislocate. You can do anything you want after a hip replacement. In my experience, almost all patients who have bilateral THRs go to rehabs and not home. It is critical that the patient is aware of the risks, benefits, and alternatives of the procedure. Many manufacturers are responding to the surgeons desire for shorter stems and many are now available on the market. 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. My question is: should I just tolerate the pain and limp, or take a chance with the hip replacement. Fort Lauderdale, FL 33334 I spoke in person to probably 4-5 of his success patients and went with hearing from them. Most importantly, I would meet with your surgeon and discuss all of these concerns. The first surgeon never mentioned this condition at all. 1.2. I was thinking of a Hip Resurfacing for my left hip and was convinced by my other top hip surgeons to stay away from it. I had the surgery on June 22 and I am about 5 weeks post op. I think tennis, dancing and horseback riding are fine. Despite the fact that this usually takes two weeks or longer, patients can return to work when they feel completely comfortable. Risks of SUPERPATH hip replacement surgery Risks due to the surgery may include (but are not limited to): Pain Bleeding Infection Permanent or temporary nerve damage Extra bone or tissue damage Drop in blood pressure during the procedure Leg deformity Blood clot or clots (that could travel to heart or lungs) Delayed wound healing I was told the joint lubricant had migrated into the hip bone creating the cyst, There is effusion in the joint and stress areas. Getting those studies will not change the reality that you will need THRs. An anterior approach to hip replacement allows the surgeon to perform more limited views of the hip joint during the surgery, making the procedure technically challenging for less experienced surgeons. 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. 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. Hospitsl staff Because of the straightforward exposure of the femur, there is less risk of femoral fracture or poor implant positioning. Check to enable permanent hiding of message bar and refuse all cookies if you do not opt in. It exploits the inter-muscular interval between the tensor fascia lata and the gluteus medius. I am a 70 yr old female with a 4grade thickness loss at acetabulum and head of femur. What are your thoughts with regard to Stem cell therapy in lieu of THR? 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 Once again, it sounds as if you had a wonderful surgeon, which is the most important variable. This often leads to a less than optimal component position. The SuperPath procedure was designed to replace the joint while sparing as much tissue as possible, substantially improving patients' recovery time. There is less blood loss with a single THR than a bilateral, hence less risk of needing a transfusion. We need 2 cookies to store this setting. hi im following as im due a superpath soon, there is no one size fits all everyones different I've had 2 hip replacements in 2 yrs one in 2017 then a revision to change the ball and socket to the smallest one they had and now I'm going for a smaller stem I had the anterior approch done which is in the front which is way better then the posterior as the front they can just move ur muscles over to the side to accsess ur hip rather then go through the back or side where they have to cut the muscles. There tends to be a lesser incidence of posterior instability with the anterior approach. Would appreciate any input you might have on the auto immune issue, and weight etc. The pain is really inconsistent, one min I will be walking fine and the next it catches and is very painful, then it may go away or may not. Because the muscle fibers are separated, not cut, the nerve path is not disturbed and the muscle is not injured. That's all I know. I also would encourage pool walking or swimming. My physical life is diminished. It also is more difficult for patients with some patterns of arthritis such as protrusio, which causes the worn out ball to migrate inward rather than upward into the socket. The vast majority of my patients return to work one to three weeks post-operatively. Finding the right surgeon is critical, because your care is about so much more than just fixing your hip. Infection. Regardless, the overall incidence of dislocation for every approach is smaller due to use of larger femoral heads and enhanced closure techniques. not moderated or reviewed by doctors and so you should not rely on opinions or advice given by other users in We may request cookies to be set on your device. The surgery time is much less with a single joint and therefore the sterile surgical instruments are opened and exposed to the environment for a shorter time. Dr. Tom Miller gives you the five best options for hip replacement surgery. Dear Dr. Leone: If you were in Los Angeles and needed a THR who would you choose to do your surgery? results, I decided to see and orthopedic doctor was advised to have THR. That being said, you should have the additional surgery where you feel you will have the best chance of doing well. More likely, its because ones activity increases after the first THR. The big difference in anterior vs posterior hip replacement is primarily where the incision is made and how long it is. Patients who are significantly overweight (I specifically assess the amount of tissue between the skin overlying the lateral hip and the greater trochanter), who have significant long-standing contractures and restricted ROM, congenital dislocation, and marked acetabular protrusion (when the femoral head wears centrally into the acetabulum) typically require a larger incision and more soft tissue releases. Soft tissue contractures often are associated with long-standing arthritis. These scores are not aggregated. Should one of these events occur during a mini-posterior procedure, they are easier to recognize and correct. 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. Doc says once recovered I should avoid flexion with adduction and internal rotation. I cant find anything that addresses replacing a hip that is dysplastic. I needed no physical therapy at all. more nutritious, too. I also regularly receive Rolfing treatments which has helped me manage pain and maintain what mobility I have. Click to enable/disable _gat_* - Google Analytics Cookie. It also keeps the surrounding muscles and tendons in place to reduce the risk of post-op pain and nerve damage. I have not seen this before because in the past, the complication from hip surgery were sciatic nerve injury from posterior approach. I was told to wait 6 weeks before I resumed my exercise regiment. The information I have gathered seems to indicate the anterior approach is more inherently stable, making precautions unnecessary. Have you recovered by now? By continuing to browse the site, you are agreeing to our use of cookies. 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. Surgical Approaches To Hip Joint Dr. Apoorv Jain D'Ortho, DNB Ortho . These stems are a new design, and therefore do not have an established track record. 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. Complications from infection account for approximately 10% of all cases. Dr. William Leone. Complications Achieving legs that feel equal in length after surgery is imperative. People who have anterior hip replacements tend to stop using walkers, canes, and other aids 5 to 7 days sooner than people who have conventional hip surgery. There are risks and recovery times associated with surgery. 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. Does anyone ever attempt to do both at the same time if THR is determined? This is described as a posterior approach because the actual hip . A long surgery time, on the other hand, was also associated with DAA. Thank you for sharing with others the nerve supplements that youre finding affective. 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. Having a THR is a major undertaking and it is reasonable to expect the hip construct to function optimally for twenty and more years. Patient is a UK registered trade mark. When a dysplasic hip is reconstructed to THR, its important the abnormal mechanics are corrected, typically by medializing (closer to the midpoint of the body or bladder) the cup. Hip implants are medical devices intended to restore mobility and relieve pain usually associated with arthritis and other hip diseases or injuries. This site uses cookies. Thank-you. 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. Personally, I would not gamble with my health. For many years, I performed bilateral THR and bilateral TKR procedures, but have backed away for a variety of reasons. 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. I wish you the best of luck. In 2013 I had a THA done on the left hip. But this will always prompt you to accept/refuse cookies when revisiting our site. The art of surgery should mimic a well rehearsed ballet or symphony. My question is, I am a very active 67 yr old. Also, if this nerve injury occurred, I would expect these symptoms to be present immediately surgery, not five months post-op. Diagnosed possible labral tear. Sometimes, it simply isnt possible to accomplish. I wish you a full and speedy recovery. This does not necessarily mean they will have more pain or take longer to get well. As of 2020 only Dr. Leone is using the latest hip technique called the SPAIREtechnique where patients no longer have hip precautions after surgery. The socket of the pelvis is machined into a hemisphere and a metal hemisphere is inserted into the socket. We are now in a situation where we have found two extremely good surgeons and we gel with both extremely well. 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. The anterior approach typically does not violate this structure. Also, patients with shorter femur necks and genu varus (lower angle between the shaft of the femur and the femoral neck) are more difficult anteriorly. Welcome to Brandon Orthopedics! 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 live in the UK so again Im afraid I wont be able to consult you personally! The best of luck to you, 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. Need to choose, then select doctor based on that decision. Sitting seems to irritate it the most. Some surgeons will use 2 incisions, both the anterior and superior approach. For risks she mentioned all the usual I knew about from the first surgery blood clots/loss, dislocation, etc. I am looking at how many hips they have done and where they are doing them. If you would like a personal consultation, please contact our office at 954-489-4584 or by email at LeoneCenter@Holy-cross.com. Your blog on anterior vs posterior approach was very informative. We are an online blog dedicated to providing comprehensive and accurate information about orthopedics and injury prevention. The femur is prepared with the head and neck intact reducing the chance of fracture. Dr. William Leone. Specific protocols, therapy and what positions you will be asked to avoid after surgery and for how long will be directed by your surgeon. Avascular Necrosis AVN of the femoral head happens when part of the ball at the top of your thigh bone loses blood supply, causing that segment of bone to die. Hip pain, soreness, and stiffness can quickly become unbearable and sideline us from the things we enjoy the most. 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. From what Ive seen, most THR patients dont need very much PT, although I do encourage exercising in a pool. About this injury to me. I came home with crutches, abandoned them at the front door and have not used them since. An artificial joint is used to replace the worn out hip joint during a hip replacement procedure known as posterior hip replacement. I have had both hips replaced about 13 months apart, one anterior and one posterior, and there is no doubt that I would recommend anterior. Finally, hip replacement surgery is expensive and may not be covered by insurance. Ultimately, it is important to discuss all of the available options with your doctor to determine which method of hip replacement is best for you. Dear Mary, I am a competitive tennis player in my age division. The most important thing is that tissue is handled gently and trauma is minimized, whichever approach is used. I feel that at 10 weeks with profuse denervation potentials on the quad muscles, the prognosis is not good, even at 6 months. If a revision were necessary, even more bone must be destroyed to remove it. Thank you. Before proceeding, it is a good idea to review the recommendations and specific parts that your surgeon may recommend. In the dark to find out about this myself. I worry that replacing it with a differently configured socket could make things worse rather than helping. Comments about life-long hip restrictions between Posterior, Anteriorlateral and Anterior approaches? I would rather see my patients go home. 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. SuperPATH is a micro-invasive method of performing a standard total hip replacement where the surgeon utilizes a smaller initial incision and, more importantly, a very limited dissection in the deep tissues. I have/had arthritis in my hips. Patients mobilize the day of surgery and typically go home the next day. 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. 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. Can you explain this approach? Disadvantages of the anterior approach include: The nerve which supplies sensation to the front and side of the thigh is vulnerable. Celle said: Superpath may give you a faster early recovery, but whatever method is used, recovery is still going to take a long time. I definitely would not recommend a hip scope and THR during one anesthetic setting. No one tells me the same thing? We are always refining and trying to make it better. 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. My mom is obese, short and has osteoporosis. Individual results and activity levels after surgery vary and depend on many factors including age, weight and prior activity level. Thanks! There are many different quality implants (just like surgeons and hospitals). My strategy is to make as small an incision as possible, but one that allows for excellent exposure and reconstruction without brutalizing the tissues. With SuperPath, there is no surgical dislocation of the hip. The approach planned is a frequent topic of Continued

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