I would not change the position of the components. You should not proceed unless you know in your heart that you will be taken care of in a manner that has the best chance of giving you as perfect a result as possible. I was discharged within 24 hours. Ten years ago I had total hip replacement on the left at hss. I live in Staten Island and need rt hip replacement. How long will my hip replacement last in your opinion? You can be successful by staying healthy by sticking to less pain. After reading your articles, I have decided not to have anterior. The SUPERPATH technique is a tissue-sparing procedure. You should consult with your doctor before deciding to have an anterior total hip replacement. A hip replacement is a common type of surgery where a damaged hip joint is replaced with an artificial one (known as an implant). Surgeons do not cut across muscles. In 2010, more than 310,000 hip replacements were performed in the United States. This site uses cookies. Choose your surgeon and not the approach or prosthesis. Introduction The first is that it is a major surgery, so there is a risk of complications such as infection. 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. 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. Click to enable/disable Google reCaptcha. However, I now have quite severe OA in my right hip apparently I have no cartilage left and have been told by a surgeon that I am just lucky not to be in constant pain. This effectively moves the hip joint center, toward the bladder or midline, and improves hip mechanics. I think cutting muscle was in the past. So frustrating. This too will lower your anxiety and improve your experience. Share your concerns with your surgeon. 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. 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! 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. 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. I would like your opinion. I plan to retire from working full time June 2017 and am concerned about having appropriate insurance after that. About my surgery: I had to wait 30 hours before surgery, two days later I was released, within two more days I stopped using my walker. Im so against any other replacements as I have other issues, but working with alternative treatments, out of pocket money, as my hip replacement has been a horrible drama/saga. 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. Potentially there also is less pain and a quicker recovery. Hello Dr Leone, This approach has a number of potential advantages, including a shorter hospital stay, less pain, and a quicker recovery. While it is a surgery that does help many, many people, clearly you are struggling. 5. Does the mini posterior hip replacement conserve more femur and allow for future surgeries if needed ? I wish you the best of luck with your care. The doc I saw yesterday said 4 weeks. Orthop Clin North Am. It is critical that the patient is aware of the risks, benefits, and alternatives of the procedure. 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. I had an anterior approach hip replacement. No groin pain NOW.but all the other mess of it all. How the soft tissues are handled and respected, the patients expectations before the surgery and the surgeons experience do. I now need the right hip replaced. A major hip replacement can take up to four months to fully recover from. Being out of bed and moving soon after surgery adds to a patients safety and speeds the recovery. There are a number of different potential surgical approaches available for hip replacement, each with their own potential advantages and potential drawbacks. When studying the hospital credentials, try and learn how many joint replacements are performed at that hospital each year, their infection rate and their 30-day readmission rate. There always are conditions or circumstances that may predispose one to limp or feel as if their legs are not the same length after surgery, but in my experience this is the exception. I emphasize continuing exercises at home especially walking. I think the recovery time is the same though. 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). 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. Therapy hopefully will help any contractures and scaring within your muscles that might have developed after surgery. 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. 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. Many, many interactions and decisions go into the final result as well as someones perception of his or her result and experience. To have your other hip replaced through a different approach is a decision you need to make with your surgeon. Your article is the first Ive read in which no muscle or tendons are cut in any approach other than the direct anterior approach. After the direct anterior approach, there is generally no hip precautions required, and motion is not restricted. Regarding restrictions after your hip replacement, this too is an area that has changed drastically over my 25 year career. 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. Advanced Ortho Surgeons | SuperPath Hip Replacement By far the most important variable is the doctor who is doing your surgery and managing your post-op care. 3. Occasionally this even requires making a second, separate incision. Infection. Which approach did the doctor take? Surgical Approaches in Total Hip Replacement I have dealt with my hip pain and limping for over a year, can no longer perform my daily activities, and cannot sleep well anymore. Historically short press fit stems have not done well. What surgical approach is typical for a complex total hip replacement? It seems that whatever their particular approach is that is what they sell. Consult an orthopedic surgeon who specializes in hip replacement surgery if you have a hip problem. The SUPERPATH hip replacement is a new technique using superior capsulotomy that allows for implantation of the total hip components under direct vision through a single incision. I encourage you to do the same. The hip joint can be supported by the socket, which is designed to fit over the ball and provide stability. It does sound as if proceeding with a THR is appropriate, since your attempt to repair the joint arthroscopically did not pan out. In my experience, almost all patients who have bilateral THRs go to rehabs and not home. Pros and Cons of Hip Replacement Surgery | IBJI I would focus on the individual doctor, not the approach that the individual choses to use, to deliver the best result. Long recovery but all is well. The surgical technique for a SUPERPATH Hip Replacement was developed as an advancement to traditional total hip replacement. Everyone is. Unfortunately, injury to the lateral femoral cutaneous nerve is a common complication after the anterior approach for hip replacement. I think they are happier and rehab more quickly. Regardless, the overall incidence of dislocation for every approach is smaller due to use of larger femoral heads and enhanced closure techniques. It seems, however, that at this time point, patients who have received resurfacings do as well or better than similar patients who have received total hip replacements. 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. Maybe someday our nations health care system will measure up to that of France, Norway, Switzerland and others, in which their governments are investing half of the GDP that we are wasting. Consuming excessive-fibre and wholegrain meals will assist to keep you feeling full, and will be Im 56 years of age, 6 1 and 180 pounds. Following anterior hip replacement surgery, avoid soaking in hot tub, sauna, or swimming pool immediately after surgery. 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. If you would like a personal consultation, please contact our office at 954-489-4584 or by email at LeoneCenter@Holy-cross.com. 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. Also, the choice of femoral stem is more likely to be influenced by the approach and not the persons anatomy and hip mechanics. #1. I never seem to know when I am going to get hit with pain. The mini-posterior is considered a more straightforward approach then the anterior, resulting in lesser complication rates. If you were in Los Angeles and needed a THR who would you choose to do your surgery? I was so against doing this surgery but groin pain was very bad and crushed bone in the groin. Also, patients with shorter femur necks and genu varus (lower angle between the shaft of the femur and the femoral neck) are more difficult anteriorly. Need to choose, then select doctor based on that decision. I cant find anything that addresses replacing a hip that is dysplastic. Do I have a risk of fractures during a posterior right hip revision due to my prior complications already? Im a very healthy long distance bicycle rider. Honestly, most 59-year-old active women do best with a well done THR. There is significantly less bleeding with the mini-posterior approach, notably reducing the necessity of a blood transfusion after the surgery. Share your concerns with your surgeon. I am so sorry to learn that you have had such a bad experience after THR. 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. 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. 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. Can you explain this approach? I am totally confused and dont know which procedure to choose. Still going to rehab to reduce stiffness and increase strength but I am in better shape now than before surgery. Most of the restrictions are removed at that time, although I still advise common sense, particularly for the first three or four months. Dr. William Leone. Some patients have no pain at all, which is remarkable. Because of the marked improvement in modern plastics, there is greater longevity and durability of acetabular plastic liners and larger femoral heads are used routinely which results in an improved the head/neck ratio and therefore the jumping distance for a hip to dislocate. DAA and SuperPATH were equal in functional outcome and acetabular cup positioning. Felt very uninformed and left Some surgeons will use 2 incisions, both the anterior and superior approach. Achieving legs that feel equal in length after surgery is imperative. Gililand, our physician, explained the concept of health. Get Directions, Phone: 954-489-4575 I had to cut some strength exercises out leg lifts, hip sled. I would not recommend pushing your surgeon to use one specific approach or another. but it was more torn than they thought and they had to cut out about 1/4 of it. 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). I encourage my patients to talk to other patients for whom Ive cared and learn about their experiences. Im sorry to learn that you are so disappointed with your hip replacement. I worry that replacing it with a differently configured socket could make things worse rather than helping. Why would the doctor not have that at their finger tips? You can do anything you want after a hip replacement. Hip replacement surgery is less painful than arthritis or fracture-related pain. My husband tells me that I cry out in pai as I turn over during the night. My question is, what will my restrictions be? Fewer narcotic medications are administered, resulting in a better overall recovery. I do not do hip arthroscopy. I sit on a cushion in the car to lift me up. 2023 Brandon Orthopedics | All Right Reserved, hip replacement pain reduction surgery patients, The Best Sneakers For Hip Replacement Patients, Anterior Hip Replacement Surgery: The Pros And Cons, The Truth About Spinal Stenosis: Causes Symptoms And Treatments, Can Years Of Surfing Contribute To Spinal Stenosis, The Effects Of Spinal Stenosis And Carpal Tunnel, Should I Apply Ice Or Heat To A Compression Fracture, How Does A Soft Bed Prevent Healing Of Herniated Disc, Herniated Discs: How To Sleep Without Worrying About Rupturing Your Discs, If You Have A Herniated Disc You Know The Excruciating Pain It Can Cause. It is important to understand that "less invasive" does not only refer to the incision but . This is actually a good sign. Finally, I would choose a doctor with whom you connect and whose staff is engaged and knowledgeable. There are a few disadvantages of anterior hip replacement that patients should be aware of before undergoing the surgery. Have you recovered by now? There are risks and recovery times associated with surgery. It would be interesting to hear what you have to say Doug. I am deciding that my quality of life is in the toilet and need to get the THR done. Cant afford a dislocation or other complications cause Im sole caregiver for severely handicapped son. He also used the term anterolateral. not moderated or reviewed by doctors and so you should not rely on opinions or advice given by other users in Your surgeon will know better than anyone else just how stable your new hip is immediately after your surgery and how securely the surrounding tissues were repaired after the reconstruction. Most THR patients do not need significant supervised physical therapy after surgery; they simply do well when their surgery is done well. 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. I play in the 50s age group. In my last blog post, I discussed minimally invasive surgery with regard to hip replacement. SuperPATH hip replacement Pros and Cons - Thoracentesis If its a struggle, then the situation needs to be reassessed. Evidence review for hip replacement approach - NCBI Bookshelf Thank you for this! Will meet with doctor soon but when I was finally able to really exercise after surgery I overdid it and developed plantar fasciitis. Tossed the cane at three weeks and went back to work. Im an avid skier and just found out I did not have full Anterior but rather AL. The first step to rule out infection is to have two simple blood studies done, an ESR and CRP. Click to enable/disable _gat_* - Google Analytics Cookie. I thought the newer procedure on the special table was the best way to go. There are several positions to avoid after anterior hip replacement, as they can put unnecessary stress on the new hip joint and lead to dislocation. SuperPath hip replacement is a differentiated total hip technique being performed by a growing number of experienced surgeons. It was also observed to be associated with longer surgery times. Since I previously had both knees replaced (by another surgeon) about 5 years ago and still have problems with the knees i.e. The initial recovery period typically takes six weeks or more. 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. 2. Thank you, Hip Replacement Materials Best to Worst - Bioxcellerator If so, is it possible to have both hips done at the same time? My first bike ride was 22 miles without any problems. We thank you for your readership. Apples to apples which procedure has the lowest incident of complications? Every surgery should be done with as minimally invasive approach as possible taking into account these other critical factors. Hard-on-hard bearings, such as ceramic-on-ceramic as well as metalon-metal articulations, also resulted in larger femoral heads being implanted. Other preoperative guidelines, such as using a prescribed pain medication and keeping the incision clean and dry, should also be followed by patients. The most important thing is that tissue is handled gently and trauma is minimized, whichever approach is used. Often in this group of patients, their X-rays show only minimal cartilage space compromise (it may appear thinned and irregular) and I observe at time of surgery that the labrum appears hypertrophied (to compensate for lack of head coverage) and often torn. Due to security reasons we are not able to show or modify cookies from other domains. With SuperPath, there is no surgical dislocation of the hip. If your little voice is questioning if you are overdoing it or hurting yourself, then listen to it and ease up. These can include damage to blood vessels or nerves, dislocation of the hip, and infection. The impingement can be between the metal neck of the stem and edge of the cup or between soft tissues. If so, how long until I can get back to normal living? Finally, hip replacement surgery is expensive and may not be covered by insurance. This then becomes a very difficult problem to solve. In Dr. Lawrence Dorrs opinion, doctors and hospitals should not market a specific type of surgery as the most effective. Because my husband has circulation problems in his leg and vein removed for open heart surgery last yearhis surgeon recommended the Mini posterior surgery. What you can do is keep as good an attitude as possible and keep rehabilitating your leg. I feel good now and walking good now but feel so disabled as I dont know if my hip will dislocate again.I am sorry if you may have responded to some of these questions already as it is so much information to absorb and I dont want to make a wrong decision again. I think tennis, dancing and horseback riding are fine. I am temped to wait but it is getting worse. The earlier the recovery begins, the better chance for a more-complete recovery. Possibly, its secondary to an altered gait pattern or hip mechanics. In general, if someone is dedicated to the job, the return is very quick. Hip replacement - Mayo Clinic Inpatient footage of the patient compilation has been edited out to accommodate hospital rules. He is one of the few surgeons in the U.S. that performs total hip replacement via a superior capsular approach, the most soft tissue-sparing hip replacement available and is an industry educator in the . Thank you. Length of hospital stay with SuperPath hip replacement approach. On the other hand, there may be a slightly increased incidence of anterior instability. Sometimes, when a surgeon is working too hard to reconstruct through a very small incision, the ends of the incision tear and the tissues are traumatized. Surgical Approach Types | Hip Replacement | Elvis Grandic, MD There is a chance that the hip will fall out of the socket, or that it will be levered out by twisting it. According to Dr. Rosen, the most important thing to remember is what you leave behind rather than how you get there. Gary. Dr. William Leone. The vast majority of my patients have their surgeries with a simple spinal with IV sedation so they are sleeping throughout the procedure . Clearly, he or she has earned your respect and confidence. J Bone Joint Surg Am. When the joint is held together by gravity and asymmetric anterior muscle tension, the tension between the ball and socket may change in various directions. That means you have an excellent track record. What do you mean by painful anterior scarring and soft tissue exposure and trauma? THR if a MRI or Pet Scan isnt done? My right leg is already a bit longer than the left. Once again, it sounds as if you had a wonderful surgeon, which is the most important variable. Both approaches have been shown to have potential in research. Also, how about hip restructuring instead of Total Hip Replacement. I am scheduled for total hip replacement in about 3 weeks, and none of these procedures/options were discussed with me.the surgeon just said that it was a risky surgery and he could not guarantee anything! I will let you in on something personal. SuperPath Hip Replacement? | Joint Replacement Patient Forum It is highly recommended that you avoid bending your hips and turning your feet together as part of hip precautions. Being cared for in a hospital that specializes in joint replacement and has an extensive specialty medical staff also is key. We provide you with a list of stored cookies on your computer in our domain so you can check what we stored. Ceramic-on-polyethylene is currently the most popular hip replacement material, representing 50.6% of all hip replacement cases back in 2014. I am 37 and have suffered from AVN since I was 14. I am terrified of nerve damage as I am very athletic and a previous professional ballet dancer. Does anyone ever attempt to do both at the same time if THR is determined? Thanks again for this great blog! The experiences will vary greatly . We are now in a situation where we have found two extremely good surgeons and we gel with both extremely well. Minimally Invasive Hip Replacement Procedure | Arthritis-health Dr. William Leone. My surgeon does the SuperPath method. 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. 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. Getting in and out of cars, and turning over in bed. Ultimately, it is important to discuss all of the available options with your doctor to determine which method of hip replacement is best for you. Each approach you list has advantages and disadvantages. 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. Patients are told how to use their hip after hip replacement surgeries, which is very different than the usual practice. I assume its something near my groin. But I feel that time could be lost and all my symptoms may become irreversible. as being in breach of those terms. I had my hip scoped which bought me 8 years, but need a THR now. Patient Resources Would you recommend treating plantar 1st? Please be aware that this might heavily reduce the functionality and appearance of our site. I decided to stick with my trusted orthopedic surgeon (who did two knee scopes on me) who believes the minimally invasive posterior approach is the safest approach. I choose to do them in a staged fashion because it is a significantly shorter procedure (more than half time-wise) and some think this lessens the risk of infection. A hip replacement can greatly reduce the pain associated with arthritis of the hip, with almost all patients having complete or near-complete relief. Getting those studies will not change the reality that you will need THRs. I am a very active and young 69 year old female who had a THR on my left side 5 years ago. I wish you only the best. The actual length of the incision really is not important, but rather how well the components were implanted and the hip mechanics restored. For many years, I performed bilateral THR and bilateral TKR procedures, but have backed away for a variety of reasons. I suspect there is significant underlying osteoarthritis related to your labral pathology. A hip replacement can be delayed until it is absolutely necessary if the replacement parts can fail over time. What are the risks involved? I would love to hear some stories about the SuperPath hip replacement. He strongly recommends the anterior approach as the only way to go. Supercapsular Percutaneously-Assisted Total Hip surgery or SuperPATH surgery is a novel method of hip replacement where your surgeon can perform total hip replacement through 2-3 inch incision into the tip of the hip and without dislocating the hip or damaging the surrounding soft-tissue (muscles and tendons). Diagnosed possible labral tear. Does Medicare Cover Hip Replacement Surgery? - Healthline Thank you, Rita. It also helps to stabilize the acetabular shell and prevent soft tissue irritation on the out edge of the cup. Adductors refer to a group of muscles that insert into the medial (inner) upper femur and often become contracted with an arthritic hip. Procedures Dear Dr. Leone, There are various ways of doing a hip replacement.