I have since read that hips with this condition might get worse after labrum repair due to this structural defect. One advantage the ceramic-on-polyethylene carries is the lack of . 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. I, too, am struggling which approach to have. Additionally, people with certain health conditions such as diabetes or heart disease may also not be good candidates. The information I have gathered seems to indicate the anterior approach is more inherently stable, making precautions unnecessary. I feel that at 10 weeks with profuse denervation potentials on the quad muscles, the prognosis is not good, even at 6 months. A neurologic evaluation is appropriate to rule out reversible causes, but most work-ups do not elicit the exact etiology and usually symptoms only can be managed at best. 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 think the recovery time is the same though. With much respect I look forward to your reply. Total hip replacement is a step-by-step surgery to replace the hip socket and the ball at the top of the thighbone (femur). More likely, its because ones activity increases after the first THR. The surgical technique for a SUPERPATH Hip Replacement was developed as an advancement to traditional total hip replacement. Enhanced soft tissue techniques also have been developed which more securely close the tissue around the newly placed prosthesis and set the stage for healing. Comparison of short-term outcomes between direct anterior approach (DAA) and SuperPATH in total hip replacement: a systematic review and network meta-analysis of randomized controlled trials. I then would strongly suggest you trust that person to decide what approach and what prosthesis predictably will deliver the best results. Others continue to follow traditional guidelines. It is normal to want to recover quickly and return to a very active lifestyle without pain. I wish you luck on your journey. Im so pleased to learn that you had a good experience. Each question is scored from 1-5, with 1 being no problems and 5 being severe problems. If I can put you on the spot. I'm hoping to read some posts post surgery. I had my hip scoped which bought me 8 years, but need a THR now. Most individuals who have had total hip replacement surgery fall into this category and simply resume their lives.. SuperPath brings some of the best benefits such as; earlier ambulation, no loss of strength, quicker recovery, less pain, decreased dislocation risk, and easier exposure for future revision surgery. My personal preference has changed from doing both hips during a single anesthetic to staged procedures two to three weeks apart. 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. Losing weight and strengthening your muscles pre-operatively will make surgery easier and greatly facilitate your rehab. Also I have read that there is a sharp learning curve that must take place in order to do the direct anterior approach. Risks of Hip Replacement Surgery The major risks include the following: Blood clot: We do reduce risk of this by using blood thinners (Enoxaparin, Aspirin or Coumadin), TED hose (compressive stockings) and compression boots on your feet to increase circulation. I weigh 185 and am 54 and realize its ideal to lose weight prior to surgery (working on it as always). Are these expectations realistic? Further, the extent of dissection is more minimally invasive, which also improves stability. I would love to hear some stories about the SuperPath hip replacement. Please do not take this as an attack, but your article seems biased on your experience (great results with min. 4. A THR is in my future. The other things that can affect the op is your fitness beforehand, your attitude and your age, although you may have difficulty getting younger!! We provide you with a list of stored cookies on your computer in our domain so you can check what we stored. Patient is a UK registered trade mark. This allows you to resume normal daily activities quickly while also returning to normal range of motion and function. I deal with major nerve damage on front of thigh, almost whole thigh. We are an online blog dedicated to providing comprehensive and accurate information about orthopedics and injury prevention. I have congenital hip dysplasia which has gradually caused more pain as Ive gotten older. They may be: Cemented to the bone. There arent any activities that you can do with a resurfaced hip that you cant do with a total hip. Publications 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. My second question relates to something you mentioned earlier regarding checking the published track record of the surgical team if I use an HMO, how do I find that information, and how do I know it hasnt been skewed to give more favorable results (lying with statistics)? It exploits the inter-muscular interval between the tensor fascia lata and the gluteus medius. Also, since I am only 51, I am concerned about component longevity. I suspect there is significant underlying osteoarthritis related to your labral pathology. Had arthroscopy in Jan 15, cleaned up tear and arthritis. Apples to apples which procedure has the lowest incident of complications? They also are looking into methods to reduce the risk of infections in artificial joints. When the capsule is fully healed, it forms strong ligaments that will eventually regrow (it will take about 4 months for the capsule to form again). Your frustration is completely understandable. An anterior hip replacement is not covered by a specific credential system for orthopedic surgeons. Try our Symptom Checker Got any other symptoms? As a result of the interventions, the surgeon has a better view of the hip joint. There is a chance that the hip will fall out of the socket, or that it will be levered out by twisting it. My walking is very limited, shoe is built up as leg is shorter and in recent months Ive realized my leg is bowed. I also recommend that you look at the track record and reputation of the hospital where the surgery will be performed, especially considering the underlying cardiac and vascular issues. from publication: Current and . Ive never foulnd information from any doctor or research-site but that there is always no legs-crossing, no more than 90-degrees (for the most part), and no twisting for anything but full Anterior. I havent dropped in here for a while but here I am almost 5 yrs post op Anterior and Femoral Nerve Damage is very alivewhole thigh is numb, IT band is still very sore and numb. There are many factors that contribute to whether or not someone is a good candidate for anterior hip replacement surgery. It is nice to see honest Q&A versus a marketing page. There are risks and recovery times associated with surgery. 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. results, I decided to see and orthopedic doctor was advised to have THR. Also, is it immoral for an 80 year old to have THR and cost the nations health care system $25 $35k? It helps the surgeon implant the acetabular component in a very precise position. Most importantly, I would meet with your surgeon and discuss all of these concerns. I am about 5 6 and 185 lbs, age 58, he did not think the weight was an issues. This means you could go home within 23 hours after surgery. We now have less-invasive techniques, better surgical methods of closing soft the tissue and more experience. I am suffering from a severe range of motion where I cant put my left sock on or tie my left shoe, I can barely get in and out of low cars and sitting up at a table hurts too! Sometimes, it simply isnt possible to accomplish. Update what hes cutting is the adductor so my question is the same is this just a normal part of some THRs? Finally, hip replacement surgery is expensive and may not be covered by insurance. There are a few disadvantages to hip replacement surgery. Also, if a surgeon knows in advance that a certain range of motion is desired, can they provide some adjustment in surgery to help accommodate that desired movement? Dear Dr. Leone, I furniture surfed in the house and used a stick outside.I was hopeless with crutches, but I think it is recommended we should use them, particularly to ensure we don't get a limp and build our leg up properly. This does expose the patient to more radiation but can help with component positioning and sizing. The doc I saw yesterday said 4 weeks. Le has extensive experience in primary joint replacements, complex revision surgery, periprosthetic fractures, and infection management. Dear Dr. Leone, I am having Makoplasty ( robotic imaging) to my right hip in February. It requires surgical insight and skill to accomplish. Not putting you on the spot, but would it be advantageous for me to drive 200 miles to have a consultation done by you? As for doctors, the surgeon I had came highly recommended. The parts may be attached to the bones in one of two ways. What, if anything, can be done to revive femoral nerve and get my thigh muscles back in normal? Posterior, mini posterior or anterior? Other preoperative guidelines, such as using a prescribed pain medication and keeping the incision clean and dry, should also be followed by patients. Initially I was hesitant of THR thinking I was way too young for something so drastic but Ive now been miserable enough long enough that I am welcoming the idea of surgery. A orthopedic surgeon may insert a numbing agent directly into a new joint, which can last up to 48 hours. I began using the superior approach for total hip replacement in February of 2014. . A typical recovery time from anterior hip surgery is six months. 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. Gililand, our physician, explained the concept of health. You should feel good that you are aware of your fears and that it hasnt paralyzed you into not acting. This often leads to a less than optimal component position. This is actually a good sign. Its been 8 months now. For centers like Phoenix Spine and Joint that use a robot, there is . In my experience, the restrictions (or those positions we ask our patients to avoid after surgery) have become much less limiting and are off limits for a much shorter period of time. 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. They may have a certain cut-off criteria (for example, a BMI of less than 35). Download scientific diagram | (a) Components of a total hip replacement; (b) The components merged into an implant; (c) The implant as it fits into the hip [15]. When we quote probability of longevity after hip replacement based on following people who had the operation, it is based on standard length stems. 2 x week. That I knew this recovery may take 1-2 It would be interesting to hear what you have to say Doug. Its been my experience that patients who go into surgery well informed have a better experience and seem to rehabilitate more quickly. The bone isn't dislocated in surgery. My surgeon mentioned also cutting something to free me up at the same time he will be doing the posterior approach surgery. I do participate in competitions and showcase presentations. 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. . These are some of the most grateful patients in my practice. I have done everything I can think of to preserve my right hip, but sadly this too needs replacing. 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. Most of the restrictions are removed at that time, although I still advise common sense, particularly for the first three or four months. 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 mini posterior approach essentially is the same as the traditional posterior, however a smaller incision is made and less soft tissue is exposed. There is a chance of nerve injury with any type of hip replacement. A shorter hospital stay and faster recovery are typical of this because there is less damage to the muscles. Pain modifying drugs as well and as a course of NSAIDs might also be appropriate. You are to be commended for taking the time to answer our questions. OTC nerve supplements suggested by a naturopath. The surgery is more difficult and more exacting . 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). During the procedure, the patient must have a small incision made in the side of his hip. Possible Infections Dr. Sutphen: A minimal number of surgery patients (roughly around 1%) can develop an infection around their hip replacement. If I have a 2nd revision of my right hip is it posterior approach or the mini-posterior approach as you discuss above? bible teaching churches near me. Posterior or Anterior? Im hoping to play tennis, go dancing and horseback riding once Ive healed. Nobody wanted to talk I think they are happier and rehab more quickly. Does it really not matter which approach I have, posterior or anterior? Fortunately, many folks who experience back symptoms before THR report improvement or resolution after. 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. I am thoroughly confused at this point. Because of the restricted view provided by the anterior incision, the anterior incision is a technically demanding procedure. What is the best hip replacement option: anterior or Posterior? Bleeding at the operative site can occur as a result of an anesthesia reaction, such as an allergic reaction. Mine certainly have. The Pros and Cons of Two Approaches to Hip Replacement: Mini-Posterior https://holycrossleonecenter.com/wp-content/uploads/2018/12/Screen-Shot-2018-12-10-at-3.48.24-PM.png, https://holycrossleonecenter.com///wp-content/uploads/2017/11/Leone-Center-Logo@2x.png, The Pros and Cons of Two Approaches to Hip Replacement: Mini-Posterior and Direct Anterior, Copyright 2018 - 2023 The Leone Center for Orthopedic Care. This complete wall of tissue that surrounds the new hip imparts stability. I still maintain that by far the most important decision patients must make is choosing the surgeon who will do their surgery and take care of them, then trusting that individual to choose the approach, prosthesis and make a million other decisions that deliver as perfect a result as possible. I have cared for many patients over the years with significant heart and peripheral vascular disease. It sounds as if you had a wonderful surgeon. This approach has a number of potential advantages, including a shorter hospital stay, less pain, and a quicker recovery. I wish you only the best. Our clinical information meets the standards set by the NHS in their Standard for Creating Health Content guidance. If you would like a personal consultation, please contact our office at 954-489-4584 or by email at LeoneCenter@Holy-cross.com. However, some offer greater patient benefits than others. I would rather this not happen with my right leg when I have the THR in Jan 2017. There are a number of different surgical ways (approaches) to access the hip joint. Some people also tend to form scar tissue and contracture more readily than others. I find that patients who are well informed and know what to expect prior to surgery get well even faster. Its interesting that when we critically analyze all the variables that ultimately make up the experience that one person has compared with another, or that one person experiences on one side versus the other, we come to recognize its not so straightforward. The earlier the recovery begins, the better chance for a more-complete recovery. Is THR something that can help? Im now 6 weeks out and doing good. For many years, I performed bilateral THR and bilateral TKR procedures, but have backed away for a variety of reasons. Check to enable permanent hiding of message bar and refuse all cookies if you do not opt in. emergent norm theory quizlet. Also, because technically it is easier, many patients are being reconstructed with very short stems which are press fit into the bone during an anterior approach. It's cut off and removed through the hole.
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