In 2010, more than 310,000 hip replacements were performed in the United States. They may be: Cemented to the bone. I would rather this not happen with my right leg when I have the THR in Jan 2017. 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. Better luck to you all. Total hip replacement is one of the most successful operations ever developed and is a remarkably predictable way to relieve pain from arthritic conditions. Conclusions SuperPATH approach showed better results in decreasing incision length and early pain intensity as well as improvement of short-term functional outcome. The hope is that your nerve injury will recover with time. With SuperPath, there is no surgical dislocation of the hip. Infection. Which approach did the doctor take? Possible Infections Dr. Sutphen: A minimal number of surgery patients (roughly around 1%) can develop an infection around their hip replacement. Is THR something that can help? I exhausted all other non-surgical options, such as physical therapy and meds but to no avail, so now plan to have a THR in March. Because the patient is lying on his back, it facilitates using a fluoroscope or moving x-ray throughout the procedure. By far the most important variable is the doctor who is doing your surgery and managing your post-op care. Blood clots or bleeding. Dr. Tom Miller gives you the five best options for hip replacement surgery. Will meet with doctor soon but when I was finally able to really exercise after surgery I overdid it and developed plantar fasciitis. If they did develop five months post-op, then you have to consider that it could be a manifestation of back pathology compromising a nerve root. What are the risks involved? Its been 9 months(Ive had it 2xs bf and got rid of it and have tried everything and no results this time). If so, is it possible to have both hips done at the same time? 2 x week. As noted above, because the femur is difficult to visualize, component positioning, sizing, and stability are more likely to be compromised. Also, the choice of femoral stem is more likely to be influenced by the approach and not the persons anatomy and hip mechanics. Nobody wants a long recovery. As a result of anterior hip surgery, there is little need for any special care. I'm so encouraged to hear your successful story. Patients can also have as little as a 3-inch incision. Thank you for this information. Rather, they say Bill, please just do what you have to do and do a great job. My advice is to focus on finding a surgeon with whom you are comfortable and have the best chance of doing well. Six months ago I had a right posterior THR due to severe scfe; now my right leg is 5/8 longer than my left leg. Even after the procedure is completed and the patient is on pain medications, pain and discomfort may occur in some cases. There is less blood loss with a single THR than a bilateral, hence less risk of needing a transfusion. Complications associated with an anterior approach hip replacement are similar to those associated with standard hip replacement surgeries. Remember, what youre hoping to do is have a hip construct that will last 20 years or more. One disadvantage to the mini posterior approach is that patients are instructed not to place the newly implanted leg in certain positions for the first six weeks after surgery. He strongly recommends the anterior approach as the only way to go. 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. The only problem Ive had post hip replacement is some on/off again groin pain. The hip joint can be supported by the socket, which is designed to fit over the ball and provide stability. Click to enable/disable _gat_* - Google Analytics Cookie. Fortunately, you have already experienced a THR and have done well. We now have too many other proven bearing surfaces available. There are hybrids of the surgey from what I can see. We may request cookies to be set on your device. Therapy hopefully will help any contractures and scaring within your muscles that might have developed after surgery. 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. What to Expect 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. This absolutely does not require a special table. 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. In my practice, I cement an Exeter stem in a significant percentage of my patients who undergo THR . Some surgeons will use 2 incisions, both the anterior and superior approach. The femur is prepared with the head and neck intact reducing the chance of fracture. Between your legs, you should sleep with a pillow for the next six weeks. There are several positions to avoid after anterior hip replacement, as they can put unnecessary stress on the new hip joint and lead to dislocation. Due to security reasons we are not able to show or modify cookies from other domains. (tho I am sure I asked about it ahead of time), I believe you are having trouble finding definitive answers and recommendations because every surgeon has his or her own recipe and experience and also the medical recommendations keep changing. Infection: You are given IV antibiotics before and after surgery. What determines the differences? 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 would consider talking to other patients who had their hips replaced by that physician and learn about their experiences. Ill be 60 at the time and Im 54 and weight about 130 lbs in fairly good shape. 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. 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 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. Update what hes cutting is the adductor so my question is the same is this just a normal part of some THRs? what is the super path method I've never heard of that before, superpath is just the fancy name for a smaller incision , less trauma and quicker recovery or so they say from what I have read along with more surety of the length of leg . Introduction The posterior approach is used frequently again, in large part due to the fact that it is an extensile approach. I am still a very active 67 yr old, I like to ski, bike, hike (steep terrain) with about 25 pds. Its been my experience that femoral nerves tend to recover more readily than sciatic nerves. A femoral nerve injury is devastating and is more vulnerable during an anterior approach than with other approaches. I would also like to know about the customized implant, as I havent yet heard much about it. My gait is off partially due to my hip but also I believe because of my body structure. The most important decision you must make is choosing your surgeon. In a very positive way, surgical techniques for both anterior and posterior approaches have evolved wonderfully since your surgery was done 10 years ago. Back to work/driving in 10 days. 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. Further, the extent of dissection is more minimally invasive, which also improves stability. The vascular supply of your leg must be assessed preoperatively as part of you work-up, but most do very well. I would suggest seeking out doctors who specialize in hip replacement surgery rather than general orthopedics. The vast majority of my patients have their surgeries with a simple spinal with IV sedation so they are sleeping throughout the procedure . A hospital outpatient surgery can cost between one-third and one-half the cost of an outpatient surgery atCOSC. For risks she mentioned all the usual I knew about from the first surgery blood clots/loss, dislocation, etc. 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). Any feedback will be appreciated. I saw a surgeon who does the posterior approach only and will see another on 4/14/15 who does both approaches. I tore my labrum at age 43 and only discovered then that I had bilateral dysplasia. I still have a very big limp and still undergoing physical therapy. Many of these stems have very little if any long term follow-up, although some appear to be doing well in the short term. I sit on a cushion in the car to lift me up. In hopes that THA would let me live my normal life without arthritis, instead I can barely walk more than 100 yards without having to stop, my gait is crooked causing lower back problems and my personal life is less than perfect. 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. 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. One thing I do not want is any muscles or tendons cut in the procedure. The experiences will vary greatly . It is not acceptable to lean forward while sitting down or standing up, and it is not acceptable to bend past 90 degrees (as shown in the angle in the letter L). I am a 67 year old woman who has danced semi-professionally and has always been very active including doing Ashtanga yoga and caopeira. Hi Frances, did you have surgery posterior Superpath? I think researching the hospital where you will have your surgery is very important. disadvantages of superpath hip replacement. In 2013 I had a THA done on the left hip. Historically in my practice I performed many Bilateral THR and TKR and have backed away from that practice. This is actually a good sign. Inpatient footage of the patient compilation has been edited out to accommodate hospital rules. 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. 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. If they are really happy, then you probably will be as well. Back then my surgeon advised me to perform a posterior surgery as opposed to anterior saying that I was overweight, short and a very muscular person and it would be easier and safer to do so. 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 think the recovery time is the same though. Cant afford a dislocation or other complications cause Im sole caregiver for severely handicapped son. Hip dysplasia is a very common underlying cause of hip osteoarthritis. The anterolateral approach or Watson Jones approach is one of the classical hip approaches that can produce excellent results when utilized for THR. Felt very uninformed and left In the dark to find out about this myself. 2012 Oct 17;94(20):1897-905. doi: 10.2106/JBJS.K . Following anterior hip replacement surgery, avoid soaking in hot tub, sauna, or swimming pool immediately after surgery. Also, after an accident, I had 12 screw and an L shaped plate in my heel. I was discharged within 24 hours. In the right hands, both approaches do great. 2004 Apr. Conserves the two main muscles that make up the front of the hip and upper thigh aspirated via the direct anterior approach. When discussing the options, my surgeon all of a sudden suggested performing anterior approach. I very rarely transfuse any patients now. Dr. William Leone. The anterior hip can be easily and naturally recovered by walking, simple home exercises, and isometric exercises. Nobody wanted to talk I never seem to know when I am going to get hit with pain. 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. Upgrade to Patient Pro Medical Professional? Choosing a surgeon should be based on published data (if available), as well as his or her reputation in the community, according to Dr. Delcore. The rule of thumb is that recovery occurs over a 12-18 month period following injury. Having a THR is a major undertaking and it is reasonable to expect the hip construct to function optimally for twenty and more years. More likely, its because ones activity increases after the first THR. My husband has a plastic valve (done in 86) and synthetic assending aorta and triple bypass (done in 2013)very successful surgery. 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. A modern artificial hip joint is designed to last for at least 15 years. I am scheduled to have total hip replacement surgery in 2 weeks. Its also reasonable to ask to speak to other patients who have undergone THR using this technique to learn about their experiences and results. Other preoperative guidelines, such as using a prescribed pain medication and keeping the incision clean and dry, should also be followed by patients. Original Medicare (Part A and Part B) will typically cover hip replacement surgery if it's medically necessary. Infection. Over time, some patients may acquire sensitivity or an allergy to the metal particles produced by the metal ball and socket. A hip replacement is a common type of surgery where a damaged hip joint is replaced with an artificial one (known as an implant). I have a tilted sacrum, sway back and a very large posterior. 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. My advice is to consult with your surgeon regarding how stable the replaced hip is and the most appropriate rehab to follow post-operatively. It is important that you find a doctor who is experienced in caring for people with complex issues. 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. After reading your article I am concerned about the issues you discussed. SuperPath hip replacement is a differentiated total hip technique being performed by a growing number of experienced surgeons. The femoral nerve functions to extend the knee and also is responsible for sensations over the anterior and medial aspects of the thigh, medial shin, and arch of the foot. 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.
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