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Celle said: Superpath may give you a faster early recovery, but whatever method is used, recovery is still going to take a long time. Fortunately you live in a part of the world where there are many capable orthopedic surgeons. Six weeks or longer is the exception. In my experience, almost all patients who have bilateral THRs go to rehabs and not home. Im 51, 59 and 148 and want to get back to tennis etc, this has been long frustrating process. 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. Some other methods are effective, but they are less effective for patients who leave the hospital earlier. SuperPath Tissue Sparing Hip Approach | MicroPort Orthopedics Risks of Hip Replacement Surgery The major risks include the following: Blood clot: We do reduce risk of this by using blood thinners (Enoxaparin, Aspirin or Coumadin), TED hose (compressive stockings) and compression boots on your feet to increase circulation. Click to enable/disable _gat_* - Google Analytics Cookie. What is the best stem and ball/socket combo to use for someone that ones to play tennis? How the soft tissues are handled and respected, the patients expectations before the surgery and the surgeons experience do. I, personally, have not had a patient dislocate following a primary total hip replacement in many years. SuperPath Hip Replacement - SuperPath St Louis | Orthopedic Surgeons 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. Im hoping to play tennis, go dancing and horseback riding once Ive healed. My question is, what will my restrictions be? 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. Almost all bilateral THR or TKR patients go to a rehabilitation facility after their acute stay, not home. The hip replacement needs to correct the abnormal hip mechanics that lead to the arthritis. I wish you a full and speedy recovery. I have since read that hips with this condition might get worse after labrum repair due to this structural defect. Can You Use An Inversion Table With A Hip Replacement Ultimately, you and your surgeon should discuss all procedures and technologies available and then trust that your surgeon will choose the best course of treatment and surgical procedure for you. invasive posterior vs not so good with AMIS) whilst on the other hand, with one of your replies you state that surgeon experience should be considered with AMIS success rates and in other replies stating that both alternatives are good. Does my prothesis not last as long since I am now doing a 3rd surgery? Blog 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. Consult your doctor to determine if joint replacement surgery is right for you. The surgical technique for a SUPERPATH Hip Replacement was developed as an advancement to traditional total hip replacement. Start your day off right, with a Dayspring Coffee One of the potential disadvantages is that because the surgery is performed through the front of the hip, there is a risk of damaging the hip joint and the surrounding muscles and tendons. Hip Resurfacing vs Hip Replacement: Know The Difference Comparing Short-term Outcomes After Direct Anterior and SuperPATH Hip Hip Preservation Surgery | Duke Health Having diabetes and two organ transplants does significantly increase your risk for post-op infection as well as other complications. Hello Dr Leone, I think it perfectly ok to discuss different approaches and ask for an opinion. Each approach has advantages and disadvantages. Evidence review for hip replacement approach - NCBI Bookshelf I would emphasize choosing your surgeon and not the approach. I weigh 185 and am 54 and realize its ideal to lose weight prior to surgery (working on it as always). Get Directions, Phone: 954-489-4575 What To Expect From Anterior Hip Replacement Surgery & Recovery Regarding restrictions after your hip replacement, this too is an area that has changed drastically over my 25 year career. We now have too many other proven bearing surfaces available. DAA had a lower rate of hospitalization and functional rehabilitation as compared to the lateral approach, as well as a lower perceived level of pain. I had good results into 5th month post op and then everything went downhill. The femoral prosthesis is inserted into the hollow part of the femoral shaft. but it was more torn than they thought and they had to cut out about 1/4 of it. SuperPath approach is the least invasive due in part to the minimal amount of tissue damage. Your back does need to be evaluated as well. It all comes down to the surgeons comfort as well as the patients. As for doctors, the surgeon I had came highly recommended. Help. The majority of teaching institutions in the United States continue to instruct as well as perform the traditional posterior as their primary approach. 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 think it is important to define and isolate why youre doing so poorly. THOUGHTS? 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. These stems are a new design, and therefore do not have an established track record. It is critical to consider the pros and cons of each option before making a decision. I, too, am struggling which approach to have. My doctor does not do mini posterior, therefor I have a 6 incision. If this occurs, the patient may experience pain and swelling. Having a hip replacement using SuperPath keyhole surgery 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. Hi, Does this mean my body may reject the metal of the post or cup? So im going back to the surgeon that did my left hip and left me in agonizing pain for 2 months after procedure. I would avoid the metal-on-metal articulation. Finally, because my patients are walking the day of surgery, most want to go home rather than to rehab. If so, how long until I can get back to normal living? Thank you. I think the recovery time is the same though. Yes, you can do very well. A couple of things I am hoping you will explain using laymans termology. Its been a nightmare for me going into 4 yrs post op soon. The vast majority of my patients return to work one to three weeks post-operatively. Because of the straightforward exposure of the femur, there is less risk of femoral fracture or poor implant positioning. I still have a very big limp and still undergoing physical therapy. We thank you for your readership. I ride horses, water ski and kayak. Please comment. Hips that are out of joint have an anterior hip replacement. Thanks. Nobody wants a long recovery. I wish you a full recovery. But I feel that time could be lost and all my symptoms may become irreversible. What are the experiences of other countries with THR? A hospital outpatient surgery can cost between one-third and one-half the cost of an outpatient surgery atCOSC. Can you explain this approach? Again, trust your doctor. I try not to let it get to me, but it causing me to feel handicapped. In anterior and posterior surgeries, the outcome is essentially the same a new hip. There is significantly less bleeding with the mini-posterior approach, notably reducing the necessity of a blood transfusion after the surgery. Finally, I would choose a doctor with whom you connect and whose staff is engaged and knowledgeable. Doctors use metal, ceramic, or plastic replacement parts. Your article is the first Ive read in which no muscle or tendons are cut in any approach other than the direct anterior approach. Hospitsl staff Nerve regeneration can occur up to 18 months following injury, but the chance of full recovery decreases with delay in recovery time. The surgeon I went to said he does THR using a lateral approach. Clearly, yours was. (Of course, I do.) Conserves the two main muscles that make up the front of the hip and upper thigh aspirated via the direct anterior approach. My problem isnt from a worn-down joint with no cartilage. My strategy is to make as small an incision as possible, but one that allows for excellent exposure and reconstruction without brutalizing the tissues. Thanks again! Egton Medical Information Systems Limited. Hip anatomy Patients who work for themselves are very motivated to return to work and often do so between procedures. Patients can also have as little as a 3-inch incision. Dr. Robert Sigmund is a board-certified orthopedic surgeon and a sports medicine physician based in St. Louis, Missouri. Patients are typi. Why is that? Today, everything from tools to techniques has improved. 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 . There has been an increase in the range of motion. 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. Obese or extremely muscular people may not be the best candidates for this surgical procedure. That being said, if the foot is now a much bigger problem than the hip, you may have to deal with that first. Reconstructing the opposite hip hopefully will result in legs that feel more equal. It is so important to stay focused on the outcome of your hip replacement surgery: excellent results both short- and long-term with minimal risk of injury or complication, and not lose sight of the real goal, which is to create a perfectly positioned reconstructed hip that is stable, balanced and has the best possible chance of lasting more than twenty years. A hip replacement can be delayed until it is absolutely necessary if the replacement parts can fail over time. Patients mobilize the day of surgery and typically go home the next day. More soft tissue trauma can result do to this increased difficulty in exposure and then gaining more exposure if necessary. Changes will take effect once you reload the page. This suggests that something changed after five months. 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! His hip ball was put back in the socket and he has done beautifully since. Dr. You are to be commended for taking the time to answer our questions. 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? Your out-of-pocket costs for your hipreplacement will be impacted by a number of . 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 . It also is more difficult for patients with some patterns of arthritis such as protrusio, which causes the worn out ball to migrate inward rather than upward into the socket. But this will always prompt you to accept/refuse cookies when revisiting our site. Its been 9 months(Ive had it 2xs bf and got rid of it and have tried everything and no results this time). Felt very uninformed and left I wish you well. How long will my hip replacement last? What do you consider to be the most important factors in choosing a surgeon? It does sound as if proceeding with a THR is appropriate, since your attempt to repair the joint arthroscopically did not pan out. as being in breach of those terms. Any info would be appreciated. I began using the superior approach for total hip replacement in February of 2014. . Getting those studies will not change the reality that you will need THRs. I dont know if this stems from the knee surgery but I do not believe so because I was well for about a year and a half. You can check these in your browser security settings. An anterior hip replacement does not have any limitations based on comfort. Ill be 60 at the time and Im 54 and weight about 130 lbs in fairly good shape. I had a posterior, the surgeon did not cut any muscle, they just move them now. The surgeon I saw said that my body structure and gait does not affect which approach would be ideal for my body. Lift your knee rather than your hip at the same time. I had no inkling of this till he showed me on the x-ray. I would like to share my experience with both procedures. Also, in the U.S., nearly all stems which are being implanted through the anterior approach are press-fit rather than cemented. 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. The earlier the recovery begins, the better chance for a more-complete recovery. 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). In my 25 years of practice, the variable that seems to have changed the most is how quickly people recover from this surgery when done well. If you would like a personal consultation, please contact our office at 954-489-4575 or by email at LeoneCenter@Holy-cross.com. Granted I do deal with lower back OA and right knee OA and now all worse and now foot/ankle mess, all on right hip side. Thanks so much for your help, very grateful. The same is true for a surgeon who employs the anterior or anterior technique. We provide you with a list of stored cookies on your computer in our domain so you can check what we stored. No i just had the posterior method which has a larger incision. 2 x week. A miniposterior approach uses the same intervals as the standard posterior approach but simply less tissue is released for the exposure. Both problems are on the right side of my body. In my experience, most patients who undergo a total hip replacement dont limp after their surgery and most feel their legs are the same length. Anterior hip replacement is a type of hip replacement surgery. If you have an abnormal anatomy or are morbidly obese, you may not be a good candidate. I am so sorry to learn that you have had such a bad experience after THR. respect of any healthcare matters. Above the ankle to the thigh.Had to use leg brace to My surgeon mentioned also cutting something to free me up at the same time he will be doing the posterior approach surgery. Thank you for sharing. This often leads to a less than optimal component position. 4. 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. Robert H. Sigmund, MD | Signature Orthopedics 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. In bed for long periods with little or no movement. I feel that at 10 weeks with profuse denervation potentials on the quad muscles, the prognosis is not good, even at 6 months. I had my hip scoped which bought me 8 years, but need a THR now. 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. Try our Symptom Checker Got any other symptoms? I have a good surgeon (same one as last time) but I dont know how he would feel about my asking if a mini posterior (or posterior) procedure be carried out, so as to preserve as much strength in my right leg as I now have.Do as many muscles need to be cut in the mini posterior procedure? Complications associated with an anterior approach hip replacement are similar to those associated with standard hip replacement surgeries. Dr. Himmelwright Introduces SuperPath to OIP Really Great. We have to get ok from cardiologist and get ekg, chest xray, etc. It typically requires a 4 to 5 day hospital stay, 3 to 6 month recovery period . Each surgeon approaches these issues individually. Inpatient footage of the patient compilation has been edited out to accommodate hospital rules. I didnt spend time on boards talking for eons about peoples outcomes.probably a good thing I didnt. not moderated or reviewed by doctors and so you should not rely on opinions or advice given by other users in Everyone I know that has had both posterior and anterior surgery say not to even consider posterior. There are a few disadvantages to hip replacement surgery. A ceramic-on-ceramic bearing is also a very good bearing. Upgrade to Patient Pro Medical Professional? Length of hospital stay with SuperPath hip replacement approach. I think researching the hospital where you will have your surgery is very important. Original Medicare (Part A and Part B) will typically cover hip replacement surgery if it's medically necessary. I think stem cell injections will have little chance of doing any good if indeed your hip condition has already progressed to bone on bone. 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. Finally, many people who are struggling with hip disease experience lower back pain or even sciatic discomfort. Orthop Clin North Am. I would like your opinion. It normally takes about 3-6 weeks to resume normal household activities and about 12 weeks to resume recreational activities like bicycling or golfing. Surgical Approach Types | Hip Replacement | Elvis Grandic, MD Additionally, there is a small risk of dislocation after surgery, which can be painful and may require additional surgery to correct. There is a more than 200% chance of knee infection, most likely because the knee has more surfaces that can become infected with an infection. The SUPERPATHTM procedure provides a number of advantages over traditional hip replacement surgery. Im so pleased to learn that you had a good experience. I deal with OA lower back mess so know I see most likely how all this has played into the surgery. The most common type of total hip replacement is done in the anterior anterior part of the hip. The posterior approach, then, is less inherently stable but may or may not require precautions. Click to enable/disable _ga - Google Analytics Cookie. I understand and respect that many surgeons prefer doing them simultaneously. I am 5 weeks out and have been doing beautifully! I typically do hip replacement on the get anterior approach in 90% of my patients. I saw a surgeon who does the posterior approach only and will see another on 4/14/15 who does both approaches. Six months ago I had a right posterior THR due to severe scfe; now my right leg is 5/8 longer than my left leg. Dear Dr. Leone, The bone isn't dislocated in surgery. Usually a hip problem is addressed before a knee or foot problem because by solving the hip problem first, the knee or foot often improves if the pain is referred from the hip (more common with knee pain) or if by addressing the hip, the body mechanics and the fluidity of gait improve. Hip Replacement Surgery | Superpath Hip Replacement Sydney Australia