Remain upright . The vast majority of my patients have their surgeries with a simple spinal with IV sedation so they are sleeping throughout the procedure . Cant afford a dislocation or other complications cause Im sole caregiver for severely handicapped son. 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. It helps the surgeon implant the acetabular component in a very precise position. 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. Some surgeons will use 2 incisions, both the anterior and superior approach. Studying a hospital and physicians track record before you commit is important. Dr. William Leone. Please do not take this as an attack, but your article seems biased on your experience (great results with min. Most activities of daily living have an element of hip flexion (knee up to head), which is a safe position after the anterior total hip. I began using the superior approach for total hip replacement in February of 2014. . Thank you so much for taking the time to inform us! The hip joint needs to be replaced again when it no longer works properly because of a revision surgery. Do you have any thoughts on this issue? I would like your opinion on the stem cell injections as I am really afraid of the second surgery on the same side of my body. Posted Both problems are on the right side of my body. I have linked back to several blog posts below that will give you more in-depth information. The surgeon does about 200 a year and people say he has a good reputation. What, if anything, can be done to revive femoral nerve and get my thigh muscles back in normal? Thank you. Would you recommend treating plantar 1st? Im ready to have the surgery, having been basically bone on bone for several years. These are some of the most grateful patients in my practice. Conclusions SuperPATH approach showed better results in decreasing incision length and early pain intensity as well as improvement of short-term functional outcome. Over the years, these precautions and the length of time to adhere to these limits have been challenged both by clinicians and patients. Mayo Clinic researchers have studied ways to reduce blood loss, control pain and speed recovery for people who undergo hip replacement surgery. 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. Adult patients who have a deteriorated hip may be candidates for total hip replacement. Adductors refer to a group of muscles that insert into the medial (inner) upper femur and often become contracted with an arthritic hip. On July 17th, I had a left THR. Your frustration is completely understandable. Each approach has advantages and disadvantages. Patients who are significantly overweight (I specifically assess the amount of tissue between the skin overlying the lateral hip and the greater trochanter), who have significant long-standing contractures and restricted ROM, congenital dislocation, and marked acetabular protrusion (when the femoral head wears centrally into the acetabulum) typically require a larger incision and more soft tissue releases. A miniposterior approach uses the same intervals as the standard posterior approach but simply less tissue is released for the exposure. 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. 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. Most of my patients now go home the day after their surgery or the next. My first bike ride was 22 miles without any problems. THR if a MRI or Pet Scan isnt done? Im a very healthy long distance bicycle rider. Introduction. Thank you, Rita. I spoke in person to probably 4-5 of his success patients and went with hearing from them. I have a tilted sacrum, sway back and a very large posterior. The second most-common injury is to the femoral nerve. My advice is to consult with your surgeon regarding how stable the replaced hip is and the most appropriate rehab to follow post-operatively. 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. There are many benefits to posterior hip replacement surgery including a quicker return to daily activities, a more natural feeling hip joint, and a decreased risk of dislocation. Thank you so much for your answer, I appreciate your taking the time to care about others. 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). It is important that the individual who ultimately implants your next THR uses the approach which he or she feels comfortable with and has the best chance to deliver the optimal result. In Dr. Lawrence Dorrs opinion, doctors and hospitals should not market a specific type of surgery as the most effective. There has been an increase in the range of motion. I didnt spend time on boards talking for eons about peoples outcomes.probably a good thing I didnt. Being out of bed and moving soon after surgery adds to a patients safety and speeds the recovery. Your primary goal should be to find a surgeon in whom you trust and who will take the workmans compensation insurance. . The SUPERPATHTM procedure provides a number of advantages over traditional hip replacement surgery. Every . Inpatient footage of the patient compilation has been edited out to accommodate hospital rules. Also, be aware that as the nerve recovers, the smallest C fibers within the nerve recover first, which can cause a burning discomfort. A typical recovery time from anterior hip surgery is six months. If I have a 2nd revision of my right hip is it posterior approach or the mini-posterior approach as you discuss above? Traditional hip replacement surgery is no longer an option, but it is less painful and has a number of advantages. There is some concern that this weakens the abductor and leads to a limp. 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. Sometimes during surgery it is necessary to release particularly tight structures to expose the joint for reconstruction or to better balance surrounding soft tissues after reconstruction. As you can see, there are no restrictions. Advanced Ortho Surgeons | SuperPath Hip Replacement Walker to get around. Registered number: 10004395 Registered office: Fulford Grange, Micklefield Lane, Rawdon, Leeds, LS19 6BA. I also think infection must be investigated and ruled out. It was also observed to be associated with longer surgery times. Time will tell if this generation of shorter press-fit stems fares as well. I wish you only the best, 2. I encourage my patients to talk to other patients for whom Ive cared and learn about their experiences. Even after the procedure is completed and the patient is on pain medications, pain and discomfort may occur in some cases. I wish you a full recovery. Contact Dr. Moor, Orthopedic Surgeon at Advanced Sports Medicine Center. Depending on the degree of injury, you may need a knee brace to lock you knee in extension when walking until the quad function returns. Because the patient is lying on his back, it facilitates using a fluoroscope or moving x-ray throughout the procedure. Patient Concerns There tends to be a lesser incidence of posterior instability with the anterior approach. 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. 1.2. This risk is greatest in older females with bone of sub-optimal quality. I never seem to know when I am going to get hit with pain. what is the super path method I've never heard of that before, superpath is just the fancy name for a smaller incision , less trauma and quicker recovery or so they say from what I have read along with more surety of the length of leg . Potentially there also is less pain and a quicker recovery. The best of luck to you, It is important that you find a doctor who is experienced in caring for people with complex issues. J. Dear Dr. Leone, I would suggest seeking out doctors who specialize in hip replacement surgery rather than general orthopedics. There are 5 questions, mobility, self-care, usual activities, pain and anxiety. Would not make eye contact. In my practice, patients who undergo a THR using a mini posterior or posterior approach: 1. Femoral nerve function also should be assessed. With much respect I look forward to your reply. This surgical procedure is performed with a patient lying on their side, and a surgical incision made along the outside of the hip. Hip Replacement | Types, Approach, and Surgical Recovery It sounds like he did fabulous job. Dear Dr. Leone, 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. It seems that whatever their particular approach is that is what they sell. 1000 NE 56th Street, 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. With a bilateral procedure during a single anesthetic, the blood loss would be double and there would be a much higher likelihood that my patient would need transfusion post-operatively. The same is true for a surgeon who employs the anterior or anterior technique. It's what compelled me to seek out different methods and post here.. You will find the surgeons will all give the pros but never the cons what ever the method. A modern artificial hip joint is designed to last for at least 15 years. Hard-on-hard bearings, such as ceramic-on-ceramic as well as metalon-metal articulations, also resulted in larger femoral heads being implanted. Does either procedure in this discussion present restrictions or advantages for this sort of movement? There are a number of different surgical ways (approaches) to access the hip joint. Publications The hip joint can be supported by the socket, which is designed to fit over the ball and provide stability. There is also a risk of the hip joint not fusing correctly, which can lead to pain and instability. Have you heard of something like this, and if so, is it worth it? Dr. William Leone. The size and placement of the incisions will be different. The rest is marketing. The initial recovery period typically takes six weeks or more. The first is that it is a major surgery, so there is a risk of complications such as infection. 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. Our second opinion doctor performs traditional and Birmingham hip replacement. It's a hip replacement surgery where you lie on your side. Can you explain it to me as he didnt go into detail. Some people also tend to form scar tissue and contracture more readily than others. I had my hip scoped which bought me 8 years, but need a THR now. Others will be empowered when they read and relate to you and/or your experience. I went with a total hip replacement. 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. What is SuperPath hip replacement? 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. In the right hands, both approaches do great. Thanks again! I typically do hip replacement on the get anterior approach in 90% of my patients. I am looking at how many hips they have done and where they are doing them. Read our editorial policy. My question is: should I just tolerate the pain and limp, or take a chance with the hip replacement. Conserves the two main muscles that make up the front of the hip and upper thigh aspirated via the direct anterior approach. Is Less-Invasive Hip Replacement Best for You? - WebMD I just had mine 10/30 all I can say is be patient get lots of rest and take your pain meds way before you start to move around so that the pain want be so bad with movement. Long recovery but all is well. Hip replacement - Mayo Clinic Posterior or Anterior? Some in the early period have good track records, others do not. I take care of many individuals who have a total knee and hip replacements on the same side. and Privacy Policy and steps will be taken to remove posts identified 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. appropriate medical assistance immediately. I have been less active this past year and am concerned that losing weight prior to surgery might be an issue, Am also wondering about my auto immune issues and the implant. A hip replacement is an excellent option for people who suffer from significant pain and disability as a result of arthritis in the hip joint. Thank you. I wish you a full and satisfactory recovery. While new techniques, instruments and prostheses have been developed specifically for minimally invasive surgeries, there are many well-established approaches to hip replacement. Possibly, its secondary to an altered gait pattern or hip mechanics. Is a prerequisite for THR to have a MRI or Pet Scan? I ask my patients to restrict certain positions that exceed the mechanical limits of the artificial hip for the first six weeks. The main limitation after surgery is a lack of comfort. I wish you only the best. My mom is obese, short and has osteoporosis. Our overall findings suggested that the short-term outcomes of THA through SuperPATH were superior to DAA. Does this mean my body may reject the metal of the post or cup? Thanks. Personally I had the posterior approach and cannot see how I could have recovered any faster . What is most important is that you find a surgeon who understands the particular complexities with your problem and whom you trust. Some people may find that traditional hip replacement surgery is the best option for them, while others may prefer a minimally invasive procedure. The last page is asking the participant to self score their health that day out of 100. Because of this, when you're ready to get up and walk about again, engaging your muscles and hip flexors might be extremely tough. I try not to bring up my mess but its hard when its with one 24/7. Full Function, Faster . Also, is it immoral for an 80 year old to have THR and cost the nations health care system $25 $35k? I have had problems with my hip for the last several yrs. When we quote probability of longevity after hip replacement based on following people who had the operation, it is based on standard length stems. The source of your hip pain must be diagnosed. Because the patient is lying on his back during the procedure, fluoroscopy or moving x-rays are used to aid in the examination. Hip Replacement Surgery | Superpath Hip Replacement Sydney Australia Otherwise you will be prompted again when opening a new browser window or new a tab. This is because the nerve is located in front of the hip. There are a few disadvantages to hip replacement surgery. Since my acetabulum is too shallow, and other angles are off as well, how does the new cup get positioned correctly? This robotic technique can assist in producing an excellent result. Considering I had no idea about differences between the two approaches, I said OK and surgery did go well and I was back on my feet in no time. Intervals between muscles are separated or muscles are separated in line with their fibers without injuring the muscles innervation. Start your day off right, with a Dayspring Coffee Because the mini-posterior is more straightforward, many surgeons think it provides an increased margin of safety for the patient, because the incision can easily be extended if exposure is poor, or if a fracture occurs. Notes on SuperPath experiences good or bad, https://patient.info/forums/discuss/superpath-experiences-good-or-bad-718788. Others continue to follow traditional guidelines. Soon my right hip started bothering me. This complete wall of tissue that surrounds the new hip imparts stability. I love that you take time off to reply to these messages it is commendable. I am just under 5 ft and weigh 185. I would rather see my patients go home. We can help you make the best decision for your knee replacement, and our friendly staff is available to answer any questions you may have. The surgeon I went to said he does THR using a lateral approach. In anterior and posterior surgeries, the outcome is essentially the same a new hip. I would not change the position of the components. Nerve regeneration can occur up to 18 months following injury, but the chance of full recovery decreases with delay in recovery time. As of 2020 only Dr. Leone is using the latest hip technique called the SPAIREtechnique where patients no longer have hip precautions after surgery. Having physio All: Once again, I think your decision to proceed with THR is the most reasonable. Return to the work place is an individual decision. We are always refining and trying to make it better. Consuming excessive-fibre and wholegrain meals will assist to keep you feeling full, and will be Finding the right surgeon is critical, because your care is about so much more than just fixing your hip. I would research and find the physician and hospital that will give you the best chance of doing well. This site uses cookies. I prefer spinal anesthesia when possible because fewer drugs are used and often the experience is gentler. Dr. William Leone. We have an appointment today to discuss the plan of action. SuperPath Hip Replacement Baton Rouge | SuperPath Surgeons Baton Rouge This allows you to resume normal daily activities quickly while also returning to normal range of motion and function. However, some offer greater patient benefits than others. This often leads to a less than optimal component position. My strategy is to make as small an incision as possible, but one that allows for excellent exposure and reconstruction without brutalizing the tissues. Clots can form in the leg veins after surgery. I am deciding that my quality of life is in the toilet and need to get the THR done. Click to enable/disable _gid - Google Analytics Cookie. That being said, in order to meet your goals, if need to leave your area and consult with surgeons in other areas, I think that is reasonable also. These can include damage to blood vessels or nerves, dislocation of the hip, and infection. Posterior hip surgery may be the best option if your surgeon makes a larger incision at the side or back of the hip joint. As of 2020 only Dr. Leone is using the latest hip technique called the. In 2014 I had to do another THA, this time on my right side. Fax: 954-489-4584 This is used when the cartilage in the hip is severely damaged by osteoarthritis or other conditions. My question is, what will my restrictions be? I am 37 and have suffered from AVN since I was 14. So im going back to the surgeon that did my left hip and left me in agonizing pain for 2 months after procedure. 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 deal with major nerve damage on front of thigh, almost whole thigh. I also have undiagnosed neuropathy in both legs from the knees down. No Muscles Cut is for billboards. The anterior approach has a lower incidence of sciatic nerve injury and a higher incidence of femoral nerve injury. 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. If this occurs, the patient usually requires a total hip replacement. What is the best hip replacement option: anterior or Posterior? Hip Replacement Surgery Technique Pros & Cons | Portsmouth Surgical Approaches in Total Hip Replacement Because the femur is more difficult to expose during the anterior approach vs. the posterior approach, many surgeons will select a shorter femoral component to facilitate reconstruction and lessen chance of fracture. 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. 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. Some surgeons believe that a patient who is neither obese nor overly muscular is a good candidate for anterior hip replacement surgery. My husband tells me that I cry out in pai as I turn over during the night. Because visualizing the femur is easier, an experienced surgeon can choose the most appropriate femoral implant rather than just the one that is easiest to implant, taking into account the patients bone quality, activity level and age. I was so against doing this surgery but groin pain was very bad and crushed bone in the groin. It is much better to precisely release and cut rather than tear or fracture. There are hybrids of the surgey from what I can see. Will I still be able to do the things I like to do? A lot of hospitals and ambulatory surgical centers offer what's called outpatient surgery. Should I look to another approach and surgeon? There are many different quality implants (just like surgeons and hospitals). Do either of your techniques require the traditional anterior or posterior precautions? I believe this is an important discussion you should have with your surgeon preoperatively. We provide the best cash prices and customer care in the industry. I believe going home is very therapeutic and often safer. Hip Replacement Surgery: How it Works, Recovery Time | HSS Ten out of every fifteen hip replacements will be functional for more than 20 years after they are inserted. Also, how about hip restructuring instead of Total Hip Replacement. 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. 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. I had posterior and much like the superpath trussed into the jig . disadvantages of superpath hip replacement When discussing the options, my surgeon all of a sudden suggested performing anterior approach. I am a competitive tennis player in my age division. 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. Celle said: Superpath may give you a faster early recovery, but whatever method is used, recovery is still going to take a long time.