Ill know a lot more after we meet and I review your X-rays. Also, in the U.S., nearly all stems which are being implanted through the anterior approach are press-fit rather than cemented. If not, what will my restrictions be? My doctor does the Posterior approach, he didnt say anything about the mini part. The hip joint can be supported by the socket, which is designed to fit over the ball and provide stability. This is described as a posterior approach because the actual hip . I wish you luck on your journey. In comparison to traditional methods, anterior approaches to the hip joint are more effective. I then would trust your doctor to select the prosthetic that would deliver the best result according to your goals and allow you to return to activities that you enjoy. More soft tissue trauma can result do to this increased difficulty in exposure and then gaining more exposure if necessary. I have/had arthritis in my hips. Your article has made it clear I made the correct decision, especially since my daughter had nerve damage from an operation years ago. 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. It typically requires a 4 to 5 day hospital stay, 3 to 6 month recovery period . 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 prefer spinal anesthesia when possible because fewer drugs are used and often the experience is gentler. Obese or extremely muscular people may not be the best candidates for this surgical procedure. There is less blood loss with a single THR than a bilateral, hence less risk of needing a transfusion. Hip replacement surgery can open up a world of possibilities for people who have lived with pain and restricted movement. The surgeon I expect to use does the Direct Anterior approach. I wish you only the best, As you can see, there are no restrictions. Lastly, where can I find a great surgeon that takes FL Workmans Comp? We have an appointment today to discuss the plan of action. I am a South African and need to make a decision on whether my mother (69) goes for an AMIS or traditional posterior. My two questions are: 1. I think they are happier and rehab more quickly. Each approach you list has advantages and disadvantages. I think the money you spend to have a hip replacement is more than just moral or justified, it is smart business. After all, no matter the age, it will determine the likelihood of maintaining your mobility and independence. 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. 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. Infection. You should avoid sitting in low chairs, beds, or toilets. If so, how long until I can get back to normal living? Patients understand the risks that metal joints and sockets bring to their long-term health and are moving away from the material. Finally, I would choose a doctor with whom you connect and whose staff is engaged and knowledgeable. On the other hand, there may be a slightly increased incidence of anterior instability. Adult patients who have a deteriorated hip may be candidates for total hip replacement. The surgeon I saw said that my body structure and gait does not affect which approach would be ideal for my body. Can you please on the various points in the post and perhaps also elaborate on the last point. I have congenital hip dysplasia which has gradually caused more pain as Ive gotten older. Hip replacement surgery is typically performed in a hospital and requires at least one night in the operating room. There are risks and recovery times associated with surgery. Dear Dr. Leone: What Ive seen in my practice is that the more total hips I do, the less restrictions I place on my patients and the more active my patients are. In some individuals, it takes much more force and dissection in order to accomplish this (typically, there is significantly more bleeding from an anterior approach compared to a mini-posterior approach). 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. Both of these are very successful ways of doing a hip replacement. General comments will be answered in as timely a manner as possible. Had a total hip replacement aug 2013. I would rather see my patients go home. Studying a hospital and physicians track record before you commit is important. Thanks for any feedback. A THR is in my future. Dr. Leone, I am coming in to see you for an appointment for a THR to my left hip. The approach planned is a frequent topic of Continued What is the best stem and ball/socket combo to use for someone that ones to play tennis? If an MRI demonstrates no cartilage damage or subchondral cystification (the development of degenerative cysts), a repairable labral tear and minimal dysplasia, then a hip arthroscopy may be considered. I exhausted all other non-surgical options, such as physical therapy and meds but to no avail, so now plan to have a THR in March. I weigh 185 and am 54 and realize its ideal to lose weight prior to surgery (working on it as always). The posterior approach is used frequently again, in large part due to the fact that it is an extensile approach. Any feedback will be appreciated. You should feel good that you are aware of your fears and that it hasnt paralyzed you into not acting. A shorter hospital stay and faster recovery are typical of this because there is less damage to the muscles. 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. Potentially there also is less pain and a quicker recovery. Can I expect any problems with the bilateral it was my choice. If you would like a personal consultation, please contact our office at 954-489-4584 or by email at LeoneCenter@Holy-cross.com. Understand that every total hip, no matter which approach is used to implant it, has the potential to dislocate. Additionally, people with certain health conditions such as diabetes or heart disease may also not be good candidates. Also congenital pulmonary hypertension (PA pressure about 52) and have hashimotos hypothyroid, and two additional auto immune issues ( alopecia and psoriasis of feet),and hypertension. I wish you a full and satisfactory recovery. Dr. William Leone. In bed for long periods with little or no movement. 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. Many of these stems have very little if any long term follow-up, although some appear to be doing well in the short term. Time will tell if this generation of shorter press-fit stems fares as well. I think it perfectly ok to discuss different approaches and ask for an opinion. 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. The posterior approach is used by a small percentage of people. I was so against doing this surgery but groin pain was very bad and crushed bone in the groin. We thank you for your readership. Hospitsl staff One thing I do not want is any muscles or tendons cut in the procedure. My clinical impression is that more patients experience some degree of residual groin discomfort or tightness after the anterior approach as compared to the posterior approach, but that it tends to resolve with time. 4 mts later am using Most individuals who have had total hip replacement surgery fall into this category and simply resume their lives.. Its been my experience that femoral nerves tend to recover more readily than sciatic nerves. Because I have scfe also in my left hip, I will have to have it fixed too. The idea is it should be a little less painful if the muscle, tendons and nerves are not disturbed. No i just had the posterior method which has a larger incision. The surgeon does about 200 a year and people say he has a good reputation. Other conditions, to which you alluded, such as having a back condition and an arthritic knee and foot, all can masquerade what the real or most debilitating problem is. Do either of your techniques require the traditional anterior or posterior precautions? 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]. Can you explain this approach? I had good results into 5th month post op and then everything went downhill. I seem to be able to hike just fine up hill and down but not always on the flat. Of note, I am a RN with 30 years of experience and took this decision very seriously. 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. Report / Delete Reply kelly1010 nicole66881 Appalachian orthopedic surgeons perform revision surgery as well as mini-posterior and anterior approaches. This allows you to resume normal daily activities quickly while also returning to normal range of motion and function. 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. I think there may be increased associated complications. I'm scheduled for THR on the 22nd. 1000 NE 56th Street, It was discovered that I had a torn Labrum. 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. I am experiencing pai. The anterior approach, as opposed to the lateral or posterior approach, uses a small incision in the front of the hip. I wish you the very best, Can you compare/contrast to the other approaches; posterior, mini posterior, anterior? Additionally, there is a small risk of dislocation after surgery, which can be painful and may require additional surgery to correct. 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. 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. Most patients are able to walk the day of surgery. My personal preference has changed from doing both hips during a single anesthetic to staged procedures two to three weeks apart. If youve had a failed hip arthroscopy, almost certainly you also have acetabular pathology and a total hip rather than a partial hip replacement may give you a more consistent, longer-lasting and more perfect result. Thanks. You can resume your active lifestyle as soon as possible thanks to a new prosthetic hip. The surgical technique for a SUPERPATH Hip Replacement was developed as an advancement to traditional total hip replacement. We want the forums to be a useful resource for our users but it is important to remember that the forums are There is a chance of nerve injury with any type of hip replacement. 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 . An anterior capsule is the only soft tissue cut during this procedure to insert the implants. Even if the hip doesnt dislocate, prosthetic or soft tissue impingement is not beneficial. I have read your articles about procedures (anterior vs posterior). I think the recovery time is the same though. No feeling in my leg and no movement disadvantages of superpath hip replacement. DAA and SuperPATH were equal in functional outcome and acetabular cup positioning. He is highly respected by the medical and chiropractic community, so i plan to have a appointment to discuss his plans for my surgery. This is actually a good sign. An anterior-approach hip replacement necessitates a small incision in the groin area on the front side of the leg. Im 51, 59 and 148 and want to get back to tennis etc, this has been long frustrating process. Dear DR Leone, Its also reasonable to ask to speak to other patients who have undergone THR using this technique to learn about their experiences and results. I would focus on the individual doctor, not the approach that the individual choses to use, to deliver the best result. results, I decided to see and orthopedic doctor was advised to have THR. Total hip replacement is one of the most successful operations ever developed and is a remarkably predictable way to relieve pain from arthritic conditions.

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