Regardless, the overall incidence of dislocation for every approach is smaller due to use of larger femoral heads and enhanced closure techniques. 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 Australian so no business from me but it has helped me become happier with my prospective surgeons judgement that he will offer me a posterior THR (hopefully the minimally invasive) when my insurance allows the procedure to occur. I have not seen this before because in the past, the complication from hip surgery were sciatic nerve injury from posterior approach. The initial recovery period typically takes six weeks or more. I ride horses, water ski and kayak. My worry is that I will end up with one leg shorter than the other. If your surgeon did a great job, that is something to respect. We want the forums to be a useful resource for our users but it is important to remember that the forums are
I should think that all your expectations are appropriate for the activities you look forward to, especially considering youve already done so well after your knee replacement. Nerve regeneration can occur up to 18 months following injury, but the chance of full recovery decreases with delay in recovery time. What to Expect Hip replacement via SuperPATH approach had a longer operation time than hip replacement via conventional approaches. This is used when the cartilage in the hip is severely damaged by osteoarthritis or other conditions. A major hip replacement can take up to four months to fully recover from. I really dont know where to go from here. Such joint replacement orthopaedic surgery is generally conducted to relieve arthritis pain or in some hip fractures.A total hip replacement (total hip arthroplasty or THA . Did you have the surgery via Superpath method? We use cookies to let us know when you visit our websites, how you interact with us, to enrich your user experience, and to customize your relationship with our website. Not putting you on the spot, but would it be advantageous for me to drive 200 miles to have a consultation done by you? I also regularly receive Rolfing treatments which has helped me manage pain and maintain what mobility I have. A hip replacement can greatly reduce the pain associated with arthritis of the hip, with almost all patients having complete or near-complete relief. My surgeon does the SuperPath method. That being said, if the foot is now a much bigger problem than the hip, you may have to deal with that first. Advantages of an anterior approach to hip replacement A major muscle is not cut during the anterior procedure. Also, when a single joint is replaced versus bilateral, there is significantly less bleeding and hence a much decreased need for transfusion. Very slow recovery. Regarding restrictions after your hip replacement, this too is an area that has changed drastically over my 25 year career. I think it was sensible being careful on the other hand and I was told not to cross my legs. I definitely would not recommend a hip scope and THR during one anesthetic setting. I also would find out your surgeons recommendation regarding activities and restrictions. I would stay away from narcotics. SuperPATH is a micro-invasive method of performing a standard total hip replacement where the surgeon utilizes a smaller initial incision and, more importantly, a very limited dissection in the deep tissues. Choose your surgeon. 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. After reading your article I am concerned about the issues you discussed. The majority of teaching institutions in the United States continue to instruct as well as perform the traditional posterior as their primary approach. 1000 NE 56th Street,
I think its always beneficial to speak to other patients who have been cared for by that physician and learn about their experiences and results. While new techniques, instruments and prostheses have been developed specifically for minimally invasive surgeries, there are many well-established approaches to hip replacement. Fewer narcotic medications are administered, resulting in a better overall recovery. Have you heard of something like this, and if so, is it worth it? I encourage my patients to talk to other patients for whom Ive cared and learn about their experiences. My question is, what will my restrictions be? 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. http://holycrossleonecenter.com/blog/hip-resurfacing-or-total-hip-replacement-a-candid-discussion/, http://holycrossleonecenter.com/blog/metal-on-metal-hip-replacements/, I wish you the very best recovery. These stems are a new design, and therefore do not have an established track record. With degenerative osteoarthritis of the hip developing secondary to a severe slipped capital femoral epiphysis (scfe), recreating normal hip mechanics after THR may have necessitated lengthening the first hip. An artificial joint is used to replace the worn out hip joint during a hip replacement procedure known as posterior hip replacement. The Hanna bed, general anesthesia machines, spinal setup, medications, ventilation, instruments, and their sterilization are all prerequisite. Dr. William Leone, Hello Dr. I believe choosing your physician is the most important decision you can make. This absolutely does not require a special table. 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. The best of luck to you, Remember, what youre hoping to do is have a hip construct that will last 20 years or more. I sit on a cushion in the car to lift me up. I ski, hike (steep terrain) with a pack -about 25 pds, kayak, horse back ride, swim, water ski and bike, which is getting increasingly more difficult. The mini-posterior is considered a more straightforward approach then the anterior, resulting in lesser complication rates. It seems that whatever their particular approach is that is what they sell. 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. results, I decided to see and orthopedic doctor was advised to have THR. There are many effective approaches and techniques that allow implantation of a total hip. Spring 2014 had trouble playing tennis, hip kept feeling like it was popping out of joint, groin pain, aching. SuperPath hip replacement is a differentiated total hip technique being performed by a growing number of experienced surgeons. Thanks. Will I still be able to do all of these things? Click to enable/disable essential site cookies. What is most important is that you find a surgeon who understands the particular complexities with your problem and whom you trust. Only Dr. Leone will be using the most recent hip technique known as the SPAIRE technique as of 2020. [QxMD MEDLINE Link]. Also, how about hip restructuring instead of Total Hip Replacement. The surgeon I went to said he does THR using a lateral approach. By 2016 and over 300 SuperPATH cases, the results of very first 100 SuperPATH surgeries (the so called 'learning Curve') were published in a peer reviewed journal with . Ill know a lot more after we meet and I review your X-rays. appropriate medical assistance immediately. It is difficult to get that from information which I find curious. I am temped to wait but it is getting worse. How long will my hip replacement last? Dear Jo Anna, The anterolateral approach or Watson Jones approach is one of the classical hip approaches that can produce excellent results when utilized for THR. The hip joint needs to be replaced again when it no longer works properly because of a revision surgery. Some patients who have recently had anterior hip replacement may suffer from complications such as wound healing. No one tells me the same thing? For risks she mentioned all the usual I knew about from the first surgery blood clots/loss, dislocation, etc. For centers like Phoenix Spine and Joint that use a robot, there is . In the case of a worn or damaged ball and socket, artificial parts can be used to restore joint function. Thank you so much for taking the time to inform us! By adhering to the surgeons instructions as well as their pre- and post-operative instructions, you can reduce your chances of complications. There is a chance of nerve injury with any type of hip replacement. Surgeons do not cut across muscles. This treatment is commonly recommended for patients suffering from osteoarthritis of the hip. Does this mean my body may reject the metal of the post or cup? Because the gluteus medius and minimus lie over the anterior capsule and insert into the greater trochanter, it does require greater trochanter osteotomy or more commonly a partial elevation of these muscles from their insertion, which can lead to damage. If this occurs, the patient usually requires a total hip replacement. What reasons would there be to use the regular over the mini? This improved quality of life will be beneficial. 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. The main limitation after surgery is a lack of comfort. He is highly respected by the medical and chiropractic community, so i plan to have a appointment to discuss his plans for my surgery. Your primary goal should be to find a surgeon in whom you trust and who will take the workmans compensation insurance. Driving hurts too. Although Superpath hip replacement is often a safe treatment, it may be associated with certain concerns, such as increased postoperative pain, as with any surgical procedure. Following the anterior approach, we provide you with a number of precautions and positions that you should avoid if you are in danger of being discomfited. 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! The anterior approach typically does not violate this structure. 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. Superpath total hip replacement animation. Introduction. I would avoid the metal-on-metal articulation. Sitting seems to irritate it the most. In 2014 I had to do another THA, this time on my right side. Notes on SuperPath experiences good or bad, https://patient.info/forums/discuss/superpath-experiences-good-or-bad-718788. I am a South African and need to make a decision on whether my mother (69) goes for an AMIS or traditional posterior. No feeling in my leg and no movement Is the hospital where the surgery will be performed also top rated?. The pain I get is in the groin and a sharp pain in the buttocks, that feels like muscle pain. A metal or plastic implant is used to replace a damaged or diseased hipbone. General comments will be answered in as timely a manner as possible. 3 years ago,
I suggest you discuss your concerns with your surgeon. After the direct anterior approach, there is generally no hip precautions required, and motion is not restricted. Soft tissue contractures often are associated with long-standing arthritis. I find that patients who are well informed and know what to expect prior to surgery get well even faster. As a result of anterior hip surgery, there is little need for any special care. 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. Why would the doctor not have that at their finger tips? The vast majority of my patients have their surgeries with a simple spinal with IV sedation so they are sleeping throughout the procedure . The first step to rule out infection is to have two simple blood studies done, an ESR and CRP. The particular surgeon who did your hip is also uniquely qualified to advise you with regard to the postoperative stability of your particular hip, because he or she physically tested your hip intra-operatively. These scores are not aggregated. Personally, it I were caring for you, I would have advised you exactly as the orthopedic surgeon who took care of you did. 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. A ball and socket are used to connect the new joint to the thigh bone (femoral bone), which is made of metal, plastic, and ceramic. I read hip dislocation is 28% higher after a revision, is it more then 28% after 2 revisions??? Lift your knee rather than your hip at the same time. I am planning to have a THR this summer. I, personally, have not had a patient dislocate following a primary total hip replacement in many years. What do you mean by painful anterior scarring and soft tissue exposure and trauma? 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. I am about to have a hip replacement and would like to know what kind of limitations Ill have afterward. I now need the right hip replaced. But after reading your articles, I am hesitant about that choice now. I think the recovery time is the same though. I also would encourage you to choose your surgeon first not the procedure, approach or prosthesis. Also, the choice of femoral stem is more likely to be influenced by the approach and not the persons anatomy and hip mechanics. These positions include crossing your legs, bending your hip more than 90 degrees, or lying on your stomach. Doc says once recovered I should avoid flexion with adduction and internal rotation. Thank you for this! The first is that it is a major surgery, so there is a risk of complications such as infection. Do you agree? Irrespective of the approach that is used to implant the prosthesis, the tissues that surround the new prosthetic hip must heal and mature if the hip is to achieve stability. Doctors use metal, ceramic, or plastic replacement parts. It will help desensitize and help get your muscles working in synchrony. I advise both my total hip and my total knee patients to avoid repetitive impact activities like distance running. Its been 9 months(Ive had it 2xs bf and got rid of it and have tried everything and no results this time). Seeing that a THR is considered major surgery, my question is, should I have my left hip done sooner than later to address the length difference or wait until I can no longer tolerate the pain? Hi, I wish you luck on your journey. We now have too many other proven bearing surfaces available. The new femoral prosthesis and new socket . Along these same lines, there is a smaller incidence of sciatic nerve injury with the anterior approach but an increased incidence of femoral nerve injury. Clearly, he or she has earned your respect and confidence. The earlier the recovery begins, the better chance for a more-complete recovery. A shorter hospital stay and faster recovery are typical of this because there is less damage to the muscles. I had to cut some strength exercises out leg lifts, hip sled. The risk of revision surgery after a posterior hip replacement is the most serious concern. The big difference in anterior vs posterior hip replacement is primarily where the incision is made and how long it is. My advice would be to avoid the extremes of any motion that exceed your hips ROM. It requires surgical insight and skill to accomplish. I had good results into 5th month post op and then everything went downhill. I have insurance with very high deductible and I am scared of the debts I might incur afterwards too ( where I am planning to do it I might not have to pay any money). July 2013 my left hip was scoped for a labral repair. Nobody wants a long recovery. It does sound as if proceeding with a THR is appropriate, since your attempt to repair the joint arthroscopically did not pan out. 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. Check to enable permanent hiding of message bar and refuse all cookies if you do not opt in. It exploits the inter-muscular interval between the tensor fascia lata and the gluteus medius. Thanks for any feedback. Thank you for this great informative discussion. Patients who have this surgery no longer require walkers, canes, or other aids 5 to 7 days after the operation, in comparison to those who have hip 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. An anterior capsule is the only soft tissue cut during this procedure to insert the implants. To have your other hip replaced through a different approach is a decision you need to make with your surgeon. Everyone I know that has had both posterior and anterior surgery say not to even consider posterior. Dear Dr. Leone, I am having Makoplasty ( robotic imaging) to my right hip in February. Can You Use An Inversion Table With A Hip Replacement 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. After a slip and fall at work 2 1/2 years ago I need a THR on my left hip. Dear Dr. Leone, 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. Before proceeding, it is a good idea to review the recommendations and specific parts that your surgeon may recommend. I am a 70 yr old female with a 4grade thickness loss at acetabulum and head of femur. I'm so encouraged to hear your successful story. Really Great. The physical build of some patients increases the difficulty. By continuing to browse the site, you are agreeing to our use of cookies. My question is, I am a very active 67 yr old. Im hoping to play tennis, go dancing and horseback riding once Ive healed. It turned out to be more torn than they thought and they had to cut about a forth of it out. The leg lifts really aggravate the front of the hip. Have you ever performed the Mini on a patient 1 year after major open heart surgery? There is no definitive answer to this question as different people will have different opinions and preferences. 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. J Bone Joint Surg Am. Its been 8 months now. Also had 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.