The first is that it is a major surgery, so there is a risk of complications such as infection. So my question is in relation to my body structure. respect of any healthcare matters. Tina, which procedure did you have? 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 . Tossed the cane at three weeks and went back to work. 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. An anterior-approach hip replacement necessitates a small incision in the groin area on the front side of the leg. It's a hip replacement surgery where you lie on your side. The pain I get is in the groin and a sharp pain in the buttocks, that feels like muscle pain. In comparison to traditional methods, anterior approaches to the hip joint are more effective. Once it exceeds this ROM, impingement occurs. I wrote to you in January, now my surgery is in a couple of weeks. What, if anything, can be done to revive femoral nerve and get my thigh muscles back in normal? Both approaches have been shown to have potential in research. I have seen a number of patients who were reconstructed with the anterior approach who developed painful anterior scarring after the procedure. 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. I would recommend having an honest discussion with the surgeons you are considering. It was also observed to be associated with longer surgery times. I am 5 weeks out and have been doing beautifully! I take care of many individuals who have a total knee and hip replacements on the same side. Currently, the incidence of dislocation after the posterior approach has been greatly reduced due to technique and other refinements. They thought it would give me about 5 yrs. 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. Behavior. No specifics were given to me from the orthopedist . My surgeon is doing posterior and my reason is I am self employed with limited Time off available and hope to be back to work at least walking and driving in 4 to 5 weeks is this possible? It is highly recommended that you avoid bending your hips and turning your feet together as part of hip precautions. 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. Are expected to be out of bed (hips and knees patients) the afternoon of their surgery and at least taking a few steps if not walking. 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. Fortunately, you have already experienced a THR and have done well. Welcome to Brandon Orthopedics! This is particularly true if the person is overweight, has very muscular thighs or is short. Yes, Im angry. Doctors use metal, ceramic, or plastic replacement parts. 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. Your blog on anterior vs posterior approach was very informative. 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. Total hip replacement is one of the most successful operations ever developed and is a remarkably predictable way to relieve pain from arthritic conditions. It healed well but then I got major psoas pain which a cortisone shot helped. I am an obese female and will be 62 in February. It is critical at time of surgery that an excellent range of motion be created without impingement. Fewer narcotic medications are administered, resulting in a better overall recovery. I assume PTHR is referring to partial hip replacement. I am unsure whether the minimal invasive posterior is available in SA. I would rather my patient get half as much anesthesia. There are a number of different surgical ways (approaches) to access the hip joint. Ken. The posterior approach for hip replacement surgery is by far the most common surgical technique used in the United States and throughout the world. This suggests that something changed after five months. Dr. Sigmund holds a subspecialty certificate in Orthopedic Sports Medicine. The rule of thumb is that recovery occurs over a 12-18 month period following injury. This is not true for bilateral cases. People undergoing traditional hip replacement surgery, for example, are advised not to bend at the hip more than 90 degrees for approximately six weeks after the procedure. These can include damage to blood vessels or nerves, dislocation of the hip, and infection. I wish you the best of luck with your care. I have linked back to several blog posts below that will give you more in-depth information. The surgery time is much less with a single joint and therefore the sterile surgical instruments are opened and exposed to the environment for a shorter time. This often leads to a less than optimal component position. I wish you only the best. 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 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). Also, since I am only 51, I am concerned about component longevity. Obese or extremely muscular people may not be the best candidates for this surgical procedure. 2021 May 20;16(1):324 . Thank you for this information. I think its always beneficial to speak to other patients who have been cared for by that physician and learn about their experiences and results. Ive come to the conclusion that perceived benefits do not outweigh the risks with the anterior approach, especially when I can achieve the same or more using the mini-posterior. Dear Dr. Leone: The first surgeon never mentioned this condition at all. Also, in the U.S., nearly all stems which are being implanted through the anterior approach are press-fit rather than cemented. Because the anterior hip replacement surgery is a minimally invasive procedure, no cuts are made to the muscles surrounding the hip. Long recovery but all is well. I would look at the published track record of the hospital where the surgery is scheduled to be sure its performance record is good and its incidence of infection is low. The vast majority of my patients return to work one to three weeks post-operatively. It helps the surgeon implant the acetabular component in a very precise position. I have been in pain for about a year and first though it was a back issue and it has limited my ability to stay as active as I would like. Report / Delete Reply kelly1010 nicole66881 It also helps to stabilize the acetabular shell and prevent soft tissue irritation on the out edge of the cup. A THR is in my future. Will meet with doctor soon but when I was finally able to really exercise after surgery I overdid it and developed plantar fasciitis. It normally takes about 3-6 weeks to resume normal household activities and about 12 weeks to resume recreational activities like bicycling or golfing. 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. Uncemented. We thank you for your readership. Its reasonable to inquire about his or her experience using the Mako robot. Pain is almost gone and I am beginning to get back to my life. What are your thoughts on the use of robotics? out the next afternoon and using a walking stick from day 2 to day 10 when I ditched it altogether . 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. Our overall findings suggested that the short-term outcomes of THA through SuperPATH were superior to DAA. Because of the straightforward exposure of the femur, there is less risk of femoral fracture or poor implant positioning. Can you please on the various points in the post and perhaps also elaborate on the last point. Although anterior approaches can be useful for some, they are not for everyone. The hip replacement needs to correct the abnormal hip mechanics that lead to the arthritis. Walking is the best exercise. Dr. Intervals between muscles are separated or muscles are separated in line with their fibers without injuring the muscles innervation. Hip replacement is a fantastic operation that can help relieve pain, improve daily function, and improve quality of life. I am so sorry to learn that you have had such a bad experience after THR. My hope is that some of these symptoms will improve with time. #1. Also there are concerns about disruption of blood supply to femoral head with this operation. 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 have been told that I can fly 48 hours after surgery?? Over the last six years, I have performed more than 2000 primary or first-time total hip replacements using the mini-posterior approach and I am aware of only one patient who dislocated his hip because he fell down stairs. Similarly, an engaged medical team needs to be available to help with care after surgery. If you would like a personal consultation, please contact our office at 954-489-4575 or by email at LeoneCenter@Holy-cross.com. Hip replacement currently consists of two major approaches: direct anterior and anterior approaches. It can lead to numbness in the thigh and, in rare cases, skin irritation due to the nerves presence. Hip anatomy Introduction. Your article has made it clear I made the correct decision, especially since my daughter had nerve damage from an operation years ago. 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. Why is that? There are a few disadvantages to hip replacement surgery. 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. When a patient feels better, they can return to work almost immediately, though it usually takes two weeks or longer. Fort Lauderdale, FL 33334
You can check these in your browser security settings. Have you recovered by now? I had the mini-posterior at MGH hospital. Finally, hip replacement surgery is expensive and may not be covered by insurance. SuperPATH showed better results in decreasing operation time, incision length, intraoperative blood loss, and early pain intensity. Should I be though?
Surgical Approaches Used for Hip Replacement - Verywell Health I believe going home is very therapeutic and often safer. I also would encourage you to choose your surgeon first not the procedure, approach or prosthesis. As noted above, because the femur is difficult to visualize, component positioning, sizing, and stability are more likely to be compromised. Individual results and activity levels after surgery vary and depend on many factors including age, weight and prior activity level. I am still a very active 67 yr old, I like to ski, bike, hike (steep terrain) with about 25 pds. 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. I had the surgery on June 22 and I am about 5 weeks post op. 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. It exploits the same soft intervals but it typically accomplishes prosthetic implantation and soft tissue balancing through a smaller incision and, more importantly, with less underlying soft tissue dissection. I share your concern that with profuse denervation potentials 10 weeks post injury, that the patient may have sustained a more severe injury than a neuropraxia. If your surgeon cant answer your questions about hip replacement or provides unsatisfactory answers, you may need to consult another surgeon. The mini posterior approach essentially is the same as the traditional posterior, however a smaller incision is made and less soft tissue is exposed. We may request cookies to be set on your device. I am seriously looking at the infection rate at each facility. I would anticipate that you would be able to return fully to your activity once the tissues around your total hip heel. . A metal or plastic implant is used to replace a damaged or diseased hipbone. We provide you with a list of stored cookies on your computer in our domain so you can check what we stored. To have your other hip replaced through a different approach is a decision you need to make with your surgeon. A recent article published by the Journal of Bone and Joint Surgery has demonstrated that the direct anterior hip replacement has more blood loss, a higher risk of intraoperative fractures, an overall higher complication rate and no difference in outcomes versus other techniques. More soft tissue trauma can result do to this increased difficulty in exposure and then gaining more exposure if necessary. I think they are happier and rehab more quickly. Driving hurts too. I wish you a full and satisfactory recovery. Fortunately you live in a part of the world where there are many capable orthopedic surgeons. I saw a hip surgeon last year for an opinion, but because I had almost no arthritis on the x-ray he said he saw no need for surgery. If the tissues are traumatized and / or the final components are not optimally positioned, then it certainly is not an advantage. 1. Click to enable/disable Google Analytics tracking. I think seeing several surgeons for different opinions is good judgment. After reading your article on disadvantages of anterior approach and also doing extensive online search about this subject, I came to realize that anterior approach was definitely a wrong choice considering my physical build short, muscular, overweight. Anterior vs. Posterior, Posterior vs Mini-posterior. Your back does need to be evaluated as well. Before proceeding, it is a good idea to review the recommendations and specific parts that your surgeon may recommend. I had a consult with a surgeon who does posterior and cuts muscle & tendons. If these values are elevated, further investigation with hip aspiration should be considered. Operating through too small an incision and not releasing tissue that would improve exposure and result in a more balanced joint in my opinion does a disservice. Back to work/driving in 10 days. Thank you. Dear Mary, Better luck to you all. I then would strongly suggest you trust that person to decide what approach and what prosthesis predictably will deliver the best results.
Dr. Daniel Le | Houston Methodist SuperPath is a portal assisted THA approach that accesses the capsule superiorly through the interval between the gluteus medius and piriformis without requiring the cutting of any muscles or tendons. crackling noise/pain, cannot bend them or kneel in church or get on the floor to do exercises, I am very afraid to ending up in a wheelchair or having to use a walker the rest of my life.I am a very active 65 year old, and very, very worried about the hip surgery. I am totally confused and dont know which procedure to choose. 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. Still going to rehab to reduce stiffness and increase strength but I am in better shape now than before surgery. Nerve regeneration can occur up to 18 months following injury, but the chance of full recovery decreases with delay in recovery time. I have not seen this before because in the past, the complication from hip surgery were sciatic nerve injury from posterior approach. Hi guys im 43 and live in Australia and due to have hip replacement in 7 weeks but im so confused as my surgeon is doing the posterior and im off work for 6 weeks where i here people having the anterior and going back sooner and no restrictions on hospital discharge any advice. We are always refining and trying to make it better. I'm scheduled for THR on the 22nd. Should I go for this or should I opt for the mini posterior. While new techniques, instruments and prostheses have been developed specifically for minimally invasive surgeries, there are many well-established approaches to hip replacement. I do not do hip arthroscopy. The SUPERPATH technique is a tissue-sparing procedure which aims to get patients back on their feet within days (possibly hours) instead of weeks or months. I was so against doing this surgery but groin pain was very bad and crushed bone in the groin. Patient does not provide medical advice, diagnosis or treatment. I was really careful bending etc for four weeks until I saw the physio, who said "oh you could have touched your toes if you had wanted to!" United States. Many studies suggest that any limp or clinical weakness resolves after approximately three months. The source of your hip pain must be diagnosed. Soon my right hip started bothering me. In a posterior hip replacement, the procedure is done on the side of the hip. Last summer I wiped out on my bike and snapped off the top of my right femur, with a diagonal break. I would say that in terms of posterior total hip replacement, the procedure is better than the old gold standard, which I believe was performed after 7 years and almost 1000 anterior total hips. Do you also do arthroscope surgery? What you can do is keep as good an attitude as possible and keep rehabilitating your leg. Patients who work for themselves are very motivated to return to work and often do so between procedures. Sometimes, it simply isnt possible to accomplish. You can be successful by staying healthy by sticking to less pain. Once again, I think your decision to proceed with THR is the most reasonable. Surgeons do not cut across muscles. Following anterior hip replacement surgery, avoid soaking in hot tub, sauna, or swimming pool immediately after surgery.
Can You Go Home the Same Day After Hip Replacement? Woke up with Update what hes cutting is the adductor so my question is the same is this just a normal part of some THRs?
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