The idea is it should be a little less painful if the muscle, tendons and nerves are not disturbed. Im getting close to needing my left hip done. What do you mean by painful anterior scarring and soft tissue exposure and trauma? Original Medicare (Part A and Part B) will typically cover hip replacement surgery if it's medically necessary. Even though I was positive I wanted this method done, I was still questioning my decision. Recently the doctor doing anterior decided because of thin bone, he should do direct lateral approach. 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. If was 3 weeks after discharge That means you have an excellent track record. Can you explain this approach? I also would find out your surgeons recommendation regarding activities and restrictions. I would rather my patient get half as much anesthesia. Sometimes, it simply isnt possible to accomplish. The hip joint can be supported by the socket, which is designed to fit over the ball and provide stability. I am deciding that my quality of life is in the toilet and need to get the THR done. In my experience the approach used to replace a hip does not effect how quickly a patient recovers. Read our editorial policy. 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. Length of hospital stay with SuperPath hip replacement approach. I will reiterate what I know to be true. My question is: should I just tolerate the pain and limp, or take a chance with the hip replacement. Patient Resources Pam. The surgeon does about 200 a year and people say he has a good reputation. I wish you the very best, 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). It is not a substitute for excellent surgery. 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. 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. It was discovered that I had a torn Labrum. Consuming excessive-fibre and wholegrain meals will assist to keep you feeling full, and will be A major muscle is not cut during anterior hip replacement surgery, so pain is reduced and major muscles are not cut after the operation. The approach planned is a frequent topic of Continued I encourage my patients to talk to other patients for whom Ive cared and learn about their experiences. Lastly, where can I find a great surgeon that takes FL Workmans Comp? 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. If you feel confident in your surgeon, I would discuss it frankly follow his or her guidance as to which approach and prosthesis are most appropriate to give you the best result. Most receive a simple spinal with sedation. It typically requires a 4 to 5 day hospital stay, 3 to 6 month recovery period . If you would like a personal consultation, please contact our office at 954-489-4584 or by email at LeoneCenter@Holy-cross.com. That being said, if the foot is now a much bigger problem than the hip, you may have to deal with that first. I also think its reasonable to look forward to returning to all of the listed activities that you enjoy. Before my hip problems, I really enjoyed playing golf and would like like to play again after surgery. Our insurance covers both. 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 would then let that person decide with what approach they think they can best accomplish the surgery and deliver the best result. I suspect that your surgeon has continued to refine his or her technique based on experience over the past five years, in the same way I have. I am a South African and need to make a decision on whether my mother (69) goes for an AMIS or traditional posterior. Following surgery, the surgeon will devise a routine for the patient to engage in that is both comfortable and safe. As a result of the interventions, the surgeon has a better view of the hip joint. disadvantages of superpath hip replacement Really Great. 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. I had good results into 5th month post op and then everything went downhill. Some in the early period have good track records, others do not. I thought the newer procedure on the special table was the best way to go. 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. Click to enable/disable _gid - Google Analytics Cookie. There are a few disadvantages to hip replacement surgery. Also if the mini posterior approach is so effective when would it not be preferred over the regular posterior approach? Im so pleased to learn that you had a good experience. I didnt spend time on boards talking for eons about peoples outcomes.probably a good thing I didnt. Had horrible groin pain issues and opted for the antior, I knew of nothing else as I consulted with a surgeon who was trained in anterior. I often suggest to my patients that they speak to other patients for whom Ive cared and to whom they can relate to learn about their experiences. In has been my experience in life that if others are happy and had a good experience then that speaks strongly to me, if I were to do the same thing. Also available today are larger modular heads, made possible because our plastics are so much better than years prior. I have seen 4 surgeons. SUPERPATH Hip Replacement | Bethesda Orthopaedic Institute Hospitsl staff These are some of the most grateful patients in my practice. There always are conditions or circumstances that may predispose one to limp or feel as if their legs are not the same length after surgery, but in my experience this is the exception. 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. I am unsure whether the minimal invasive posterior is available in SA. My recommendation is for you to discuss this with your surgeon if you have further concerns. I sit on a cushion in the car to lift me up. Because of this, when you're ready to get up and walk about again, engaging your muscles and hip flexors might be extremely tough. The healing and maturation of this tissue takes time. The anterior approach, as a marketing tool, has grown in popularity among surgeons. SuperPath Hip Replacement (Surgery) : 3D Animation - YouTube Can I expect any problems with the bilateral it was my choice. Diagnosed possible labral tear. Brian Tinsley. I'm hoping to read some posts post surgery. Walking is the best exercise. I had the mini-posterior at MGH hospital. 4. There is no definitive answer to this question as different people will have different opinions and preferences. My two questions are: 1. J Bone Joint Surg Am. The pain I get is in the groin and a sharp pain in the buttocks, that feels like muscle pain. The first step to rule out infection is to have two simple blood studies done, an ESR and CRP. I live in Staten Island and need rt hip replacement. Not sure exactly what that means. I went in with high expectations of coming out so much better off and here I am 5 yrs out limping more than ever and a NUMB thigh and worse knee and weak ankle. The other things that can affect the op is your fitness beforehand, your attitude and your age, although you may have difficulty getting younger!! 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. A miniposterior approach uses the same intervals as the standard posterior approach but simply less tissue is released for the exposure. I would encourage you to discuss your concerns with you surgeon. 35 (2):153-62. 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. Anterior hip replacement has the potential to cause complications and pose some risks. I had to cut some strength exercises out leg lifts, hip sled. As a result, patients can return to their normal activities much sooner than if they had had traditional hip replacement surgery. 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. What are your thoughts with regard to Stem cell therapy in lieu of THR? Patients can also have as little as a 3-inch incision. 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. We are now in a situation where we have found two extremely good surgeons and we gel with both extremely well. I deal with OA lower back mess so know I see most likely how all this has played into the surgery. Share your concerns with your surgeon. 2. Dear Jo Anna, 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 already have an artificial knee that is doing great. I am still a very active 67 yr old, I like to ski, bike, hike (steep terrain) with about 25 pds. Are these expectations realistic? I wish you a full and speedy recovery. Have you recovered by now? This interval must be developed and the muscles must be separated in order to reconstruct the hip. Risks associated with hip replacement surgery can include: Blood clots. I would rather this not happen with my right leg when I have the THR in Jan 2017. A hip replacement can be delayed until it is absolutely necessary if the replacement parts can fail over time. Over the years, these precautions and the length of time to adhere to these limits have been challenged both by clinicians and patients. The nerve which supplies sensation to the front and side of the thigh is vulnerable. What you can do is keep as good an attitude as possible and keep rehabilitating your leg. I also would encourage you to choose your surgeon first not the procedure, approach or prosthesis. This improved quality of life will be beneficial. Consult an orthopedic surgeon who specializes in hip replacement surgery if you have a hip problem. Did you have the surgery via Superpath method? Country. I do not have dials and no one seems to know where the neuropathy stems from. My strategy is to make as small an incision as possible, but one that allows for excellent exposure and reconstruction without brutalizing the tissues. I came home with crutches, abandoned them at the front door and have not used them since. Thank you. I have had problems with my hip for the last several yrs. Had a total hip replacement aug 2013. Thank you for sharing with others the nerve supplements that youre finding affective. Hi, I, too, am struggling which approach to have. I have had to modify my activity level by cutting back greatly and also trying new activities that might not strain my hips so much(tried water walking in the deep end which cause deep pain for 2-3 days afterwards). I understand they have good results in Thailand or India for half that. I wish you the best of luck, Hip replacement surgery is typically performed in a hospital and requires at least one night in the operating room. It is generally agreed that the temporary numbness is more than balanced out by the substantially improved recovery, reduced pain, absence of a limp, faster return to function, and virtual elimination of the risk of hip dislocation. I would discuss fully your goals and concerns. There is a possibility that blood loss may be reduced as there is less unnecessary exposed bone surface left to bleed. When studying the hospital credentials, try and learn how many joint replacements are performed at that hospital each year, their infection rate and their 30-day readmission rate. Many believe that this results in less risk of infection. Doc, Ive worked out and been physically active forever running, biking, skating, etc. These are all realistic goals. I think researching the hospital where you will have your surgery is very important. Total hip replacement is a step-by-step surgery to replace the hip socket and the ball at the top of the thighbone (femur). Dr. Parsons has extensive experience in the posterior, anterior and superior (SuperPATH) approach to total hip replacement having performed hundreds of each. Does my prothesis not last as long since I am now doing a 3rd surgery? Thanks! It exploits the inter-muscular interval between the tensor fascia lata and the gluteus medius. 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. Super path appears to come with it's hazards due to bone sawing rather than dislocation of the hip to be replaced, making revision much more difficult if issues occur later down the line. A hip replacement is a common type of surgery where a damaged hip joint is replaced with an artificial one (known as an implant). . According to Dr. Rosen, the most important thing to remember is what you leave behind rather than how you get there. The pain in my hip is strange in that I can hike uphill and down hill, bike and X-country ski but have a very hard time walking on the flat, especially after sitting for awhile or getting out of bed. This procedure differs from traditional hip replacements in the following ways: There is no surgical dislocation of the hip. As noted above, because the femur is difficult to visualize, component positioning, sizing, and stability are more likely to be compromised. disadvantages of superpath hip replacement My physical life is diminished. Hip replacement - NHS I suspect there is significant underlying osteoarthritis related to your labral pathology. 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. Sex After a Hip Replacement: Positions, Tips, and More - Healthline Other health issues include congenital heart ASD corrected about 12 yrs ago with an amplatzer occluder implant by the right femoral approach resulting in possible femoral nerve compression, Lateral right leg numbness and leg discomfort since the implant, Groin pain and restriction in extending the right leg back has been a problem for some time and masked the fact that at least a portion of my increasing pain was from my hip. That's all I know. I have been told that I can fly 48 hours after surgery?? You are free to opt out any time or opt in for other cookies to get a better experience. I do not do hip arthroscopy. I decided to stick with my trusted orthopedic surgeon (who did two knee scopes on me) who believes the minimally invasive posterior approach is the safest approach. Once it exceeds this ROM, impingement occurs. Extensive release of the posterior capsule including . Our overall findings suggested that the short-term outcomes of THA through SuperPATH were superior to DAA. In May of 2015, I had a Labial tear repaired. Surgical Approaches To Hip Joint Dr. Apoorv Jain D'Ortho, DNB Ortho . This does not necessarily mean they will have more pain or take longer to get well. Your symptoms still sound mechanical, positional and episodic. Third, the procedure is shorter in length and requires less hospital stay than traditional hip replacement surgery. 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. It is important to understand that "less invasive" does not only refer to the incision but . 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. In a very positive way, surgical techniques for both anterior and posterior approaches have evolved wonderfully since your surgery was done 10 years ago. Excess weight causes a hip joint that has already been stressed to become more painful and disability-causing. It is much better to precisely release and cut rather than tear or fracture. With SuperPath, there is no surgical dislocation of the hip. Disadvantages of the anterior approach include: The nerve which supplies sensation to the front and side of the thigh is vulnerable. By adhering to the surgeons instructions as well as their pre- and post-operative instructions, you can reduce your chances of complications. However, some offer greater patient benefits than others. But I feel that time could be lost and all my symptoms may become irreversible. The mini-posterior approach involves separating the muscle fibers of the large buttock muscle located at the side and the back of the hip. Will I still be able to do the things I like to do? As long as you do the necessary surgeries, you will eventually break your femur, but only if you do enough. Typically, the new cup will be medialized to gain coverage and correct the abnormality that lead to your arthritis. Time will tell if this generation of shorter press-fit stems fares as well. Talked to my foot doc and we decided on the Topaz procedure which has good results. Dr. William Leone. I also would learn about the track record of the surgeon and hospital where you will decide to have the surgery and what implant will be used. 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. Does anyone ever attempt to do both at the same time if THR is determined? We thank you for your readership. What Is Superpath Hip Replacement - HipsAdvice.com The same is true for a surgeon who employs the anterior or anterior technique. Our team of experts, doctors, and orthopedic specialists are here to share their knowledge and experience with you in order to help you make informed decisions about your health and well-being. How does it affect the actual success of the Personally I had the posterior approach and cannot see how I could have recovered any faster . disadvantages of superpath hip replacement. I love that you take time off to reply to these messages it is commendable. Before proceeding, it is a good idea to review the recommendations and specific parts that your surgeon may recommend. This is actually a good sign. Even in my practice, which is starting its 27th year, we continue to refine the surgical procedure, pre- and post-operative instructions and rehab (this is huge), pre- and post-operative pain management, and even anesthesia. No feeling in my leg and no movement Your back does need to be evaluated as well. Is Less-Invasive Hip Replacement Best for You? - WebMD Patients are told how to use their hip after hip replacement surgeries, which is very different than the usual practice. A mini posterior approach is a modification of the classical posterior approach. Apples to apples which procedure has the lowest incident of complications?