I am concerned that I may have a pinched nerve and that that is what is causing all this pai as the pain is severe only in certain positions but when I am tired I also have a throbbing pain in the sciatic region.talk about the golden yearsI thank you from the bottom of my heart for the kindness and caring that you do in answering all these questions. Publications Some of the most common considerations are age, weight, activity level, and the presence of other health conditions. The surgeon will be building a construct that hopefully will last her life time and change her life profoundly. Patient is a UK registered trade mark. My advice is to focus on finding a surgeon with whom you are comfortable and have the best chance of doing well. Thru X-rays Ive been told both hips are bone on bone! I have a yr or more off work so I have the time to heal properly but scared to sit or move an Inch as I dont want to dislocate my hip again I dislocated my left hip in a resturant while eating lunch with my 10 yr old we both suffer from ptsd now and stayed in the emergency room for 30 hrs before they rushed me to the city hospital. It's a hip replacement surgery where you lie on your side. 10 users are following. not moderated or reviewed by doctors and so you should not rely on opinions or advice given by other users in There is significantly less bleeding with the mini-posterior approach, notably reducing the necessity of a blood transfusion after the surgery. Country. Each surgeon approaches these issues individually. It is highly recommended that you avoid bending your hips and turning your feet together as part of hip precautions. 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. Adductors refer to a group of muscles that insert into the medial (inner) upper femur and often become contracted with an arthritic hip. 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. Have you heard of something like this, and if so, is it worth it? Can you explain this approach? These are some of the most grateful patients in my practice. It's cut off and removed through the hole. Would you recommend treating plantar 1st? I had an anterior right hip replacement in late 2010, I was 72. Some surgeons believe that a patient who is neither obese nor overly muscular is a good candidate for anterior hip replacement surgery. 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. 2. This then becomes a very difficult problem to solve. I have congenital hip dysplasia which has gradually caused more pain as Ive gotten older. 4. If you have an abnormal anatomy or are morbidly obese, you may not be a good candidate. (tho I am sure I asked about it ahead of time), I believe you are having trouble finding definitive answers and recommendations because every surgeon has his or her own recipe and experience and also the medical recommendations keep changing. They also are looking into methods to reduce the risk of infections in artificial joints. 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 This robotic technique can assist in producing an excellent result. Dear Dr. Leone, J Orthop Surg Res. Soft tissue contractures often are associated with long-standing arthritis. You can be successful by staying healthy by sticking to less pain. Mine certainly have. It is a pity that medicine cannot be as definitive as science but relies on historic figures and the future outcome appears to be a statistical probability! Back then my surgeon advised me to perform a posterior surgery as opposed to anterior saying that I was overweight, short and a very muscular person and it would be easier and safer to do so. Getting those studies will not change the reality that you will need THRs. Similarly, an engaged medical team needs to be available to help with care after surgery. I am a 53 year old active, distance runner. Hello Dr. (Of course, I do.) Once you find that doctor, then you need to put your trust in him or her to help you solve this horrible problem so you can return to being active and productive. The surgeon I saw said that my body structure and gait does not affect which approach would be ideal for my body. My surgeon wants to use the posterior approach and indicates that I eventually should be able to play golf again. 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. 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. Each question is scored from 1-5, with 1 being no problems and 5 being severe problems. 2012 Oct 17;94(20):1897-905. doi: 10.2106/JBJS.K . If a mini posterior approach is used and the resultant total hip has optimally positioned components and balanced soft tissues, and was implanted through a smaller incision with less underlying soft tissue dissection and trauma, then I believe it is a benefit. 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. Inpatient footage of the patient compilation has been edited out to accommodate hospital rules. I would also like to know about the customized implant, as I havent yet heard much about it. Pain Management Every patient needs to have as limited an approach and dissection as possible that does not compromise the final implant position or create excessive trauma to the soft tissues. That being said, if the foot is now a much bigger problem than the hip, you may have to deal with that first. respect of any healthcare matters. A shorter hospital stay and faster recovery are typical of this because there is less damage to the muscles. Im 51, 59 and 148 and want to get back to tennis etc, this has been long frustrating process. Do you have any thoughts on this issue? Im hearing no restrictions (once recovery is done) for Anterior, but always some for the other two. The SUPERPATHTM procedure provides a number of advantages over traditional hip replacement surgery. THOUGHTS? Two which are receiving the most attention are the traditional posterior approach and the direct anterior approach. I emphasize continuing exercises at home especially walking. 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. Thanks. Once it exceeds this ROM, impingement occurs. We have to get ok from cardiologist and get ekg, chest xray, etc. If theyre really happy and got well quickly, you probably will too. I think it was sensible being careful on the other hand and I was told not to cross my legs. If not, what will my restrictions be? An anterior hip replacement procedure, on the other hand, performs the same function as an anterior hip replacement in terms of tissue shaving. Possible Infections Dr. Sutphen: A minimal number of surgery patients (roughly around 1%) can develop an infection around their hip replacement. Our clinical information meets the standards set by the NHS in their Standard for Creating Health Content guidance. Also, how about hip restructuring instead of Total Hip Replacement. This is used when the cartilage in the hip is severely damaged by osteoarthritis or other conditions. Uncemented. Thank you, Lisa Blumthal. Our overall findings suggested that the short-term outcomes of THA through SuperPATH were superior to DAA. In the hands of a master, all can produce wonderful and predictable results. What is most important is choosing your surgeon. Can you please on the various points in the post and perhaps also elaborate on the last point. Posted I think cutting muscle was in the past. I needed no physical therapy at all. Hip replacement surgery can open up a world of possibilities for people who have lived with pain and restricted movement. Get Directions, Phone: 954-489-4575 Of note, I am a RN with 30 years of experience and took this decision very seriously. Extensive release of the posterior capsule including . The technique allows recovery that is as rapid as a mini-posterior approach while conferring stability of the hip joint that is equal to other exposures that . Im a 50 year old female whose been dealing with hip, leg and back pain for many years, recently diagnosed with OA, and finding that I need a right THR. Low-risk anterior approach patients are those who have significant deformities in their proximal femur as a result of previous trauma or dysplasia, or who have previously suffered from acetabular bone fractures. The rule of thumb is that recovery occurs over a 12-18 month period following injury. Thank you, Lisa. Surgical Approaches To Hip Joint Dr. Apoorv Jain D'Ortho, DNB Ortho . Its reasonable to inquire about his or her experience using the Mako robot. I then stage the second surgery as early as 2 or 3 weeks post-operatively. We have an appointment today to discuss the plan of action. I deal with major nerve damage on front of thigh, almost whole thigh. A hip replacement involves removing the ball (femoral head) and replacing it with a metal or ceramic prosthetic ball. Every surgery should be done with as minimally invasive approach as possible taking into account these other critical factors. Its been my experience that femoral nerves tend to recover more readily than sciatic nerves. I am a 49-year-old female. I am now 59, still in good condition but that is being compromised by lack of working out as my hips get sore from most everything I try. I am a South African and need to make a decision on whether my mother (69) goes for an AMIS or traditional posterior. You can do anything you want after a hip replacement. 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. Changes will take effect once you reload the page. About this injury to me. (I have SCD) It has now become unbearable and I am preparing for surgery. I am 5 weeks out and have been doing beautifully! I have never operated on another surgeon who asked me to make as small an incision as possible or use the minimally invasive approach. Share your concerns with your surgeon. I have the surgery planned, but then another medical professional warned me that the posterior approach will limit my twisting range of motion and prevent me from playing golf. These can include damage to blood vessels or nerves, dislocation of the hip, and infection. Fax: 954-489-4584 Hip replacements might keep you out of action for a considerable period. There is a chance of nerve injury with any type of hip replacement. 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. We are always refining and trying to make it better. My two questions are: 1. 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. The hope is that these new designs will, but time will tell. Your frustration is completely understandable. Im pleased that you will be coming in for an appointment. An anterior capsule is the only soft tissue cut during this procedure to insert the implants. The idea is it should be a little less painful if the muscle, tendons and nerves are not disturbed. Ill be 60 at the time and Im 54 and weight about 130 lbs in fairly good shape. 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. 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. Anterior hip replacement is a type of hip replacement surgery. Im hoping to play tennis, go dancing and horseback riding once Ive healed. Patients can also have as little as a 3-inch incision. 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. It seems that whatever their particular approach is that is what they sell. 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. I seem to be able to hike just fine up hill and down but not always on the flat. I would rather my patient get half as much anesthesia. The most important decision you will make is choosing your surgeon. The surgeon I expect to use does the Direct Anterior approach. I was so against doing this surgery but groin pain was very bad and crushed bone in the groin. I love that you take time off to reply to these messages it is commendable. I believe going home is very therapeutic and often safer. 2 x week. Recently the doctor doing anterior decided because of thin bone, he should do direct lateral approach. This interval must be developed and the muscles must be separated in order to reconstruct the hip. The surgeon I went to said he does THR using a lateral approach. I have had problems with my hip for the last several yrs. His hip ball was put back in the socket and he has done beautifully since. A hip replacement is a common type of surgery where a damaged hip joint is replaced with an artificial one (known as an implant). I am just under 5 ft and weigh 185. It is also important to avoid any sudden movements or twisting motions. What is SuperPath hip replacement? A lot of hospitals and ambulatory surgical centers offer what's called outpatient surgery. Hard-on-hard bearings, such as ceramic-on-ceramic as well as metalon-metal articulations, also resulted in larger femoral heads being implanted. This allows you to resume normal daily activities quickly while also returning to normal range of motion and function. If they did develop five months post-op, then you have to consider that it could be a manifestation of back pathology compromising a nerve root. There arent any activities that you can do with a resurfaced hip that you cant do with a total hip. No special surgical equipment is required when performing a mini posterior. Part of those possibilities includes a better and more comfortable sex life. hi im following as im due a superpath soon, there is no one size fits all everyones different I've had 2 hip replacements in 2 yrs one in 2017 then a revision to change the ball and socket to the smallest one they had and now I'm going for a smaller stem I had the anterior approch done which is in the front which is way better then the posterior as the front they can just move ur muscles over to the side to accsess ur hip rather then go through the back or side where they have to cut the muscles. He is passionate about helping his patients achieve the best possible outcome and is committed to providing the highest quality of care. How long will my hip replacement last in your opinion? The mini posterior approach essentially is the same as the traditional posterior, however a smaller incision is made and less soft tissue is exposed. I wish you well. This does expose the patient to more radiation but can help with component positioning and sizing. OTC nerve supplements suggested by a naturopath. In a posterior hip replacement, the procedure is done on the side of the hip. The most important thing is that tissue is handled gently and trauma is minimized, whichever approach is used. Patient Concerns This too will lower your anxiety and improve your experience. 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). I wish you a full and satisfactory recovery. Thank you for this! But this will always prompt you to accept/refuse cookies when revisiting our site. There does appear to be an increased incidence of stem instability when implanted through the anterior approach, but I believe this is largely a function of the surgeon experience. Your article lacks the pros of the AMIS and the cons of min invasive posterior. I also think its reasonable to look forward to returning to all of the listed activities that you enjoy. Click to enable/disable _ga - Google Analytics Cookie. I take care of many individuals who have a total knee and hip replacements on the same side. Additionally, people with certain health conditions such as diabetes or heart disease may also not be good candidates.