Problem is that we have seen two doctors and both seem great but are on two extreme sides of the fence. Even after the procedure is completed and the patient is on pain medications, pain and discomfort may occur in some cases. This does not necessarily mean they will have more pain or take longer to get well. When discussing the options, my surgeon all of a sudden suggested performing anterior approach. I love that you take time off to reply to these messages it is commendable. I was discharged within 24 hours. Share your concerns with your surgeon. OTC nerve supplements suggested by a naturopath. In general, I would encourage you to consider all of your prosthetic joints a remarkable modern day miracle that must be cared for and respected. I plan to retire from working full time June 2017 and am concerned about having appropriate insurance after that. Over time, some patients may acquire sensitivity or an allergy to the metal particles produced by the metal ball and socket. Dr. William Leone. The SUPERPATHTM procedure provides a number of advantages over traditional hip replacement surgery. If possible and a pool available, I encourage my patients to walk and exercise in a pool and / or swim, starting at two weeks when their suture is removed. I am a!so told by the orthopedist who referred me that I need arthroscope on my right hip. 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 would rather my patient get half as much anesthesia. We now have too many other proven bearing surfaces available. The most common type of total hip replacement is done in the anterior anterior part of the hip. Thank you, Rita. I would then let that person decide with what approach they think they can best accomplish the surgery and deliver the best result. The most important decision you will make is choosing your surgeon. There tends to be a lesser incidence of posterior instability with the anterior approach. By adhering to the surgeons instructions as well as their pre- and post-operative instructions, you can reduce your chances of complications. 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. Is a prerequisite for THR to have a MRI or Pet Scan? disadvantages of superpath hip replacement. Dont let PR marketing confuse the big picture. The vast majority of my patients have their surgeries with a simple spinal with IV sedation so they are sleeping throughout the procedure . 1. It can lead to numbness in the thigh and, in rare cases, skin irritation due to the nerves presence. There are numerous complications associated with hip replacement surgery, but blood clots in the legs and hips are two of them. Also had 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. I was initially sent to a surgeon to consider repair but he said my chances of being happy with the outcome were only 30% and suggest a THR. Thanks again for this great blog! Rush joint replacement surgeons are leaders in hip replacement surgery and research. Egton Medical Information Systems Limited. I am still a very active 67 yr old, I like to ski, bike, hike (steep terrain) with about 25 pds. Dr. William Leone. Yes, you do have increase risks. A hip replacement is a common type of surgery where a damaged hip joint is replaced with an artificial one (known as an implant). These parts have a porous coating that the bone grows into. The second advantage of a small incision is that it makes it easier to clean and care for the hip. Some patients have no pain at all, which is remarkable. 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. Other jobs, which tend to be more structured and / or more physical, may require more time off. Also many folks develop peripheral neuropathy in their lower legs, which also becomes more common with age. An operating room that can support safe Anterior or SuperPATH minimally invasive joint replacement surgery costs around $1.5 million. I suspect there is significant underlying osteoarthritis related to your labral pathology. Soon my right hip started bothering me. 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. Thank you for all you do and for providing me with the information when I needed it. My surgeon does the SuperPath method. My question is, what will my restrictions be? One thing I do not want is any muscles or tendons cut in the procedure. for Orthopedic Care 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. 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. In anterior and posterior surgeries, the outcome is essentially the same a new hip. Also available today are larger modular heads, made possible because our plastics are so much better than years prior. 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. Do I have a risk of fractures during a posterior right hip revision due to my prior complications already? If you do not want that we track your visit to our site you can disable tracking in your browser here: We also use different external services like Google Webfonts, Google Maps, and external Video providers. The most important thing is to get a top notch surgeon and go with whatever approach they offer. I would discuss fully your goals and concerns. What are your thoughts on the use of robotics? Woke up with The approach planned is a frequent topic of Continued With SuperPath, there is no surgical dislocation of the hip. During the hip replacement procedure, the surgeon makes a small incision near the front of the hip to allow for the removal of damaged anterior bone and cartilage, as well as the implantation of an artificial hip without damaging the surrounding muscles and tendons. The doctor used the posterior procedure. I think it perfectly ok to discuss different approaches and ask for an opinion. Any info would be appreciated. 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. The surgical technique for a SUPERPATH Hip Replacement was developed as an advancement to traditional total hip replacement. Update what hes cutting is the adductor so my question is the same is this just a normal part of some THRs? disadvantages of superpath hip replacement. appropriate medical assistance immediately. I have been told that I can fly 48 hours after surgery?? We have to get ok from cardiologist and get ekg, chest xray, etc. Changes will take effect once you reload the page. No i just had the posterior method which has a larger incision. I have congenital hip dysplasia which has gradually caused more pain as Ive gotten older. Almost all bilateral THR or TKR patients go to a rehabilitation facility after their acute stay, not home. Thanks again! That being said, if the foot is now a much bigger problem than the hip, you may have to deal with that first. Dr. Sigmund holds a subspecialty certificate in Orthopedic Sports Medicine. As a result of this precaution, it is difficult to sit on low chairs, sofas, or toilets. Dear Dr. Leone, All: When done well, your body does well with this technology. Also, be aware that as the nerve recovers, the smallest C fibers within the nerve recover first, which can cause a burning discomfort. Inpatient footage of the patient compilation has been edited out to accommodate hospital rules. First, I am a little bit scared. I believe a THR will benefit you tremendously. more nutritious, too. Technologies, The Leone Center Hi, 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. Thanks so much for your help, very grateful. All have advantages and disadvantages. 1000 NE 56th Street, In a very positive way, surgical techniques for both anterior and posterior approaches have evolved wonderfully since your surgery was done 10 years ago. Click to enable/disable essential site cookies. The art of surgery should mimic a well rehearsed ballet or symphony. Had arthroscopy in Jan 15, cleaned up tear and arthritis. SuperPath approach is the least invasive due in part to the minimal amount of tissue damage. Dear Dr. Leone, A hip replacement can be delayed until it is absolutely necessary if the replacement parts can fail over time. I definitely would not recommend a hip scope and THR during one anesthetic setting. I dont think one surgical approach is better or worse than the other for you to accomplish this. My doctor does the Posterior approach, he didnt say anything about the mini part. We fully respect if you want to refuse cookies but to avoid asking you again and again kindly allow us to store a cookie for that. It is important that these medical and cardiac conditions be optimized by your PCP and cardiologist preoperatively. Being cared for in a hospital that specializes in joint replacement and has an extensive specialty medical staff also is key. I am deciding that my quality of life is in the toilet and need to get the THR done. It is highly recommended that you avoid bending your hips and turning your feet together as part of hip precautions. Historically in my practice I performed many Bilateral THR and TKR and have backed away from that practice. These are some of the most grateful patients in my practice. If was 3 weeks after discharge Does this mean my body may reject the metal of the post or cup? I wish you a full recovery. 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. Please comment. Very slow recovery. The leg lifts really aggravate the front of the hip. The anterior approach is not as muscle sparing as some would argue. I cant find anything that addresses replacing a hip that is dysplastic. I just saw a patient with a femoral neuropraxia after a anterior approach THR. Can I expect any problems with the bilateral it was my choice. The idea is it should be a little less painful if the muscle, tendons and nerves are not disturbed. Long-term outcomes of SuperPATH approach need to be investigated. 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. 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. Advantages of an anterior approach to hip replacement A major muscle is not cut during the anterior procedure. Thanks for giving us patients the kind of information we need to be more educated as to what questions to ask. It's cut off and removed through the hole. I live in the UK so again Im afraid I wont be able to consult you personally! The hope is that your nerve injury will recover with time. 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. There is a chance that the hip will fall out of the socket, or that it will be levered out by twisting it. Most individuals who have had total hip replacement surgery fall into this category and simply resume their lives.. In my practice, I cement an Exeter stem in a significant percentage of my patients who undergo THR . I have a tilted sacrum, sway back and a very large posterior. How long will my hip replacement last? Dear Dr. Leone: When it comes to revision surgery, we rely heavily on the posterior approach. When people loose independence and mobility, not only does the quality of life suffer, they are much more likely to develop a myriad of medical problems requiring even more-expensive and/or long-term care, including loss of independent living. 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. I did have a total knee replaced two years ago. What has changed the most in my career, once again in a very positive way, is how quickly patients start walking (day of surgery), and go home and return to their active lives after THR, as compared with just a few years ago. 35 (2):153-62. This often leads to a less than optimal component position. I have seen 2 doctors one doing posterior, the other anterior. 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. The activity that I wish to have the most success with after the surgery is ballroom dancing. Publications Common conditions that often lead people to have either posterior or anterior hip replacement surgery include the following: Osteoarthritis Rheumatoid Arthritis Osteonecrosis, also known as Avascular Necrosis Injury Fracture Bone Tumors 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. Which approach did the doctor take? SuperPath hip replacement is a differentiated total hip technique being performed by a growing number of experienced surgeons. In my 25 years of practice, the variable that seems to have changed the most is how quickly people recover from this surgery when done well. 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. Also, how about hip restructuring instead of Total Hip Replacement. In 2010, more than 310,000 hip replacements were performed in the United States. Can you explain it to me as he didnt go into detail. 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. Specific protocols, therapy and what positions you will be asked to avoid after surgery and for how long will be directed by your surgeon. It also helps to stabilize the acetabular shell and prevent soft tissue irritation on the out edge of the cup. No, I would not tolerate the pain and immobility, if there is a reasonable way to relieve it. There are many factors that contribute to whether or not someone is a good candidate for anterior hip replacement surgery. I weigh 185 and am 54 and realize its ideal to lose weight prior to surgery (working on it as always).

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