They may be: Cemented to the bone. By continuing to browse the site, you are agreeing to our use of cookies. I would also like to know about the customized implant, as I havent yet heard much about it. THR - Posterior or Superpath Decision - Joint Replacement Patient Forum The highly crossed linked polyethylene liners are now the gold standard in this country. If so, how long until I can get back to normal living? This is actually a good sign. Click to enable/disable _gid - Google Analytics Cookie. It is critical to consider the pros and cons of each option before making a decision. The Disadvantages Of Anterior Hip Replacement Very important with both the traditional posterior and the mini-posterior approaches, if the surgeon is not able to visualize critical structure adequately, or if a problem were to arise such as a fracture, then either approach can easily be adjusted. Adductors refer to a group of muscles that insert into the medial (inner) upper femur and often become contracted with an arthritic hip. The most important decision you will make is choosing your surgeon. Therapy is often appropriate for stretching, strengthening and electrical stimulation which helps maintain the motor end plates, structures on the muscles that the nerve branches must re-innervate. I would not anticipate them improving with time, but rather worsening, and I cant imagine you being able to resume the activities you described without having surgery to treat this. 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. 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. The Pros and Cons of Two Approaches to Hip Replacement: Mini-Posterior SuperPath Hip Replacement: The Major Benefits For example, the stability of the components could have been achieved initially, but then proved inadequate so you developed either a loose cup and/or a loose stem. Share your concerns with your surgeon. Intervals between muscles are separated or muscles are separated in line with their fibers without injuring the muscles innervation. I do not want the approach to dictate the optimal construct which I hope will last 20 years and more. This is because the nerve is located in front of the hip. Did you have the surgery via Superpath method? I think the recovery time is the same though. I am 37 and have suffered from AVN since I was 14. Fort Lauderdale, FL 33334 I wish you well. Lastly, if one has had P or AL is there anything that can be done to offset the need for restricitons? Pain Management Currently we use standard ways, called either posterior or direct lateral approach. . Long recovery but all is well. An operating room that can support safe Anterior or SuperPATH minimally invasive joint replacement surgery costs around $1.5 million. Testimonials Your article has made it clear I made the correct decision, especially since my daughter had nerve damage from an operation years ago. I typically do hip replacement on the get anterior approach in 90% of my patients. Back to work/driving in 10 days. Hi, 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. Supercapsular Percutaneously-Assisted Total Hip surgery or SuperPATH surgery is a novel method of hip replacement where your surgeon can perform total hip replacement through 2-3 inch incision into the tip of the hip and without dislocating the hip or damaging the surrounding soft-tissue (muscles and tendons). Or are x-rays definitive for determining the exact reason for THR? I think tennis, dancing and horseback riding are fine. A shorter hospital stay and faster recovery are typical of this because there is less damage to the muscles. Blog Surgery carries increased risks because of these conditions, but by defining the risks and optimizing any underlying conditions, the risks can be minimized and hopefully managed. My surgeon wants to use the posterior approach and indicates that I eventually should be able to play golf again. Other conditions, to which you alluded, such as having a back condition and an arthritic knee and foot, all can masquerade what the real or most debilitating problem is. I am seriously looking at the infection rate at each facility. What do you mean by painful anterior scarring and soft tissue exposure and trauma? Im hoping to play tennis, go dancing and horseback riding once Ive healed. Hip replacement - Mayo Clinic I think stem cell injections will have little chance of doing any good if indeed your hip condition has already progressed to bone on bone. It allows the surgeon to work between the muscles and tendons without removing them from their anchoring points on the hip or thighbone. Click to enable/disable _ga - Google Analytics Cookie. Ten years ago I had total hip replacement on the left at hss. What reasons would there be to use the regular over the mini? The risk of revision surgery after a posterior hip replacement is the most serious concern. I would not recommend pushing your surgeon to use one specific approach or another. Conclusions SuperPATH approach showed better results in decreasing incision length and early pain intensity as well as improvement of short-term functional outcome. Can you suggest any pain medication that would not interfere with anti rejection drugs? Some other methods are effective, but they are less effective for patients who leave the hospital earlier. If you have these arthritis symptoms, you should consider a hip replacement: severe hip pain that is not relieved by medication and that interferes with your work, sleep or everyday activity hip stiffness that restricts motion and makes it difficult to walk To learn more, read Here's What to Know if You Think You Need a Hip Replacement. According to Dr. Gililand, patients should not try to change their surgeons opinion based on their preferences. Its been my experience that femoral nerves tend to recover more readily than sciatic nerves. Its been 9 months(Ive had it 2xs bf and got rid of it and have tried everything and no results this time). My doctor does not do mini posterior, therefor I have a 6 incision. The hip joint needs to be replaced again when it no longer works properly because of a revision surgery. Inpatient footage of the patient compilation has been edited out to accommodate hospital rules. I am so sorry to learn that you are struggling. Also congenital pulmonary hypertension (PA pressure about 52) and have hashimotos hypothyroid, and two additional auto immune issues ( alopecia and psoriasis of feet),and hypertension. I sit on a cushion in the car to lift me up. I live in the UK so again Im afraid I wont be able to consult you personally! In the front of the hip, fewer muscles are present, so the surgeon works between them instead of cutting through them and then detaching them (and then repairing them after the surgery). It is much better to precisely release and cut rather than tear or fracture. One of the biggest changes that Ive seen in my practice over the past 25 years is how quickly patients get well and go home. We now have less-invasive techniques, better surgical methods of closing soft the tissue and more experience. What is SuperPath Hip Replacement? Woke up with Hip Pain & Injury Care Sarasota, FL - Advanced Sports Medicine If your little voice is questioning if you are overdoing it or hurting yourself, then listen to it and ease up. Total hip replacement is a step-by-step surgery to replace the hip socket and the ball at the top of the thighbone (femur). Share your concerns with your surgeon. In general, people who are older, heavier, or more active may not be good candidates for this type of surgery. (PATH) and Supercapsular percutaneously assisted total hip (SuperPATH) arthroplasty: learning curves and early outcomes. When the joint is held together by gravity and asymmetric anterior muscle tension, the tension between the ball and socket may change in various directions. 5 Things to Know About Anterior vs Posterior Hip Replacement William Leone. Minimally Invasive Total Hip Arthroplasty Technique - Medscape Because the anterior hip replacement surgery is a minimally invasive procedure, no cuts are made to the muscles surrounding the hip. There tends to be a lesser incidence of posterior instability with the anterior approach. Does this mean my body may reject the metal of the post or cup? Hip replacement surgeries are becoming increasingly popular due to their numerous benefits, such as increased range of motion, reduced pain and disability, improved mobility during pregnancy, and improved quality of life. United States. Doc, Ive worked out and been physically active forever running, biking, skating, etc. The SUPERPATH technique is a tissue-sparing procedure which aims to get patients back on their feet within days (possibly hours) instead of weeks or months. 1000 NE 56th Street, Because the patient is lying on his back during the procedure, fluoroscopy or moving x-rays are used to aid in the examination. 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). That being said, you should have the additional surgery where you feel you will have the best chance of doing well. My recommendation is to go back to your surgeon and share your concerns and issues to see if a fresh and thorough reevaluation wont help define the problem(s) and solutions. 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. Others continue to follow traditional guidelines. The anterolateral approach or Watson Jones approach is one of the classical hip approaches that can produce excellent results when utilized for THR. After reading your article I see there are many reasons to go with the posterior approach but nothing about having to use a smaller prosthesis with the anterior approach. An anterior hip replacement procedure, on the other hand, performs the same function as an anterior hip replacement in terms of tissue shaving. Will I still be able to do the things I like to do? I was discharged within 24 hours. I live in Staten Island and need rt hip replacement. The most important thing is that tissue is handled gently and trauma is minimized, whichever approach is used. They may have a certain cut-off criteria (for example, a BMI of less than 35). External rotation of your feet should be limited (avoiding them twisting to the outside as Charlie Chaplin does) and hip hyperextension should be avoided. So frustrating. You can check these in your browser security settings. There are potential drawbacks to anterior hip replacement. 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.