disadvantages of superpath hip replacement

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. 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. My question is, I am a very active 67 yr old. The impingement can lead to a levering out of the ball from the socket. The development of a complete and secure surrounding scar tissue wall or pseudo capsule is critical for stability. 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. In my last blog post, I discussed minimally invasive surgery with regard to hip replacement. 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. July 2013 my left hip was scoped for a labral repair. Possibly, its secondary to an altered gait pattern or hip mechanics. 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. I live in the UK so again Im afraid I wont be able to consult you personally! The first is that it is a major surgery, so there is a risk of complications such as infection. Glad that after lots of PT and massage and medial branch block for back issues with NO!!! Which approach did the doctor take? Comparison of short-term outcomes between direct anterior approach (DAA) and SuperPATH in total hip replacement: a systematic review and network meta-analysis of randomized controlled trials. I do not have dials and no one seems to know where the neuropathy stems from. (Of course, I do.) My surgeon mentioned also cutting something to free me up at the same time he will be doing the posterior approach surgery. Still going to rehab to reduce stiffness and increase strength but I am in better shape now than before surgery. It turned out to be more torn than they thought and they had to cut about a forth of it out. I have been told that I can fly 48 hours after surgery?? There are risks and recovery times associated with surgery. I have done everything I can think of to preserve my right hip, but sadly this too needs replacing. Can you compare/contrast to the other approaches; posterior, mini posterior, anterior? Patients mobilize the day of surgery and typically go home the next day. What, if anything, can be done to revive femoral nerve and get my thigh muscles back in normal? I prefer spinal anesthesia when possible because fewer drugs are used and often the experience is gentler. They also are looking into methods to reduce the risk of infections in artificial joints. Patient is a UK registered trade mark. The surgeon I saw said that my body structure and gait does not affect which approach would be ideal for my body. Since 1995, there has been an extremely low dislocation rate and an infection rate of zero percent. I suspect that your surgeon has continued to refine his or her technique based on experience over the past five years, in the same way I have. Thanks so much for your help, very grateful. Anterior vs. Posterior, Posterior vs Mini-posterior. William Leone. To have your other hip replaced through a different approach is a decision you need to make with your surgeon. What is SuperPath hip replacement? Your out-of-pocket costs for your hipreplacement will be impacted by a number of . 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. The anterior approach has a lower incidence of sciatic nerve injury and a higher incidence of femoral nerve injury. Select a surgeon based on your impression of that individual: how engaged was he or she in your care, will you have access to that person as well as his or her team before and after surgery? Hi Frances, did you have surgery posterior Superpath? Nerve regeneration can occur up to 18 months following injury, but the chance of full recovery decreases with delay in recovery time. How do you ask your doctor the questions you want to ask? for Orthopedic Care If you would like a personal consultation, please contact our office at 954-489-4575 or by email at LeoneCenter@Holy-cross.com. 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. Introduction I never seem to know when I am going to get hit with pain. In comparison to traditional methods, anterior approaches to the hip joint are more effective. I very rarely transfuse any patients now. No i just had the posterior method which has a larger incision. Better luck to you all. I again suggest you concentrate on finding a surgeon in whom you have faith and then trust that doctor. Its been my experience that femoral nerves tend to recover more readily than sciatic nerves. We can do this because of improved plastics. When a dysplasic hip is reconstructed to THR, its important the abnormal mechanics are corrected, typically by medializing (closer to the midpoint of the body or bladder) the cup. This robotic technique can assist in producing an excellent result. Do you also do arthroscope surgery? I wrote to you in January, now my surgery is in a couple of weeks. I am 56 now and find that physical therapy and chiropractic care dont seem to be helping anymore. Your back does need to be evaluated as well. This means you could go home within 23 hours after surgery. Also there are concerns about disruption of blood supply to femoral head with this operation. Finally, many people who are struggling with hip disease experience lower back pain or even sciatic discomfort. It is critical that the patient is aware of the risks, benefits, and alternatives of the procedure. 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. 2015 Aug. 3 (13):179. I would encourage you to discuss your concerns with you surgeon. i had lateral posterior, my surgeon stopped doing anterior because he said it caused muscle problems moving them about and can also cause nerve damage, which is the main reason I did not want that approach. Posterior hip surgery may be the best option if your surgeon makes a larger incision at the side or back of the hip joint. My gait is off partially due to my hip but also I believe because of my body structure. I still have a very big limp and still undergoing physical therapy. Patients who work for themselves are very motivated to return to work and often do so between procedures. I had an anterior right hip replacement in late 2010, I was 72. I have a tilted sacrum, sway back and a very large posterior. I would love to hear some stories about the SuperPath hip replacement. Would you recommend treating plantar 1st? This can cause you persistent pain, stiffness . Changes will take effect once you reload the page. Please comment. The socket of the pelvis is machined into a hemisphere and a metal hemisphere is inserted into the socket. The anterior approach exploits an interval between muscles that cross the front of your hip and thigh. The surgical "approach" in total hip replacement describes the anatomical pathway and technique that the surgeon uses to access the hip joint to perform the surgery. Thanks. This treatment is much more definitive and predictable. 4. 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. I had to cut some strength exercises out leg lifts, hip sled. There are many factors that contribute to whether or not someone is a good candidate for anterior hip replacement surgery. J Orthop Surg Res. SuperPath approach is the least invasive due in part to the minimal amount of tissue damage. These cookies collect information that is used either in aggregate form to help us understand how our website is being used or how effective our marketing campaigns are, or to help us customize our website and application for you in order to enhance your experience. 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. 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. My surgeon wants to use the posterior approach and indicates that I eventually should be able to play golf again. 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. The vast majority of my patients have their surgeries with a simple spinal with IV sedation so they are sleeping throughout the procedure . Also, in the U.S., nearly all stems which are being implanted through the anterior approach are press-fit rather than cemented. Both problems are on the right side of my body. I would then let that person decide with what approach they think they can best accomplish the surgery and deliver the best result. He strongly recommends the anterior approach as the only way to go. Mar 13, 2013. Are these expectations realistic? I am 5 weeks out and have been doing beautifully! Also available today are larger modular heads, made possible because our plastics are so much better than years prior. For the prevention, diagnosis, and treatment of hip pain and other problems affecting your hips, call Advanced Sports Medicine Center today at (941) 957-1500. It is important that these medical and cardiac conditions be optimized by your PCP and cardiologist preoperatively. The earlier the recovery begins, the better chance for a more-complete recovery. I am a!so told by the orthopedist who referred me that I need arthroscope on my right hip. Thru X-rays Ive been told both hips are bone on bone! Irrespective of the approach that is used to implant the prosthesis, the tissues that surround the new prosthetic hip must heal and mature if the hip is to achieve stability. There is also a small risk of infection at the surgical site. The activity that I wish to have the most success with after the surgery is ballroom dancing. Notes on SuperPath experiences good or bad, https://patient.info/forums/discuss/superpath-experiences-good-or-bad-718788. The posterior approach for hip replacement surgery is by far the most common surgical technique used in the United States and throughout the world. The second most-common injury is to the femoral nerve. I dont know what type of procedure was used for my first op but it was sucessful and now can do a half lotus position with no problem.I do find however that the muscles at the front of that leg are not as strong as my unoperated right leg and lifting the left leg to a vertical position in yoga, when lying on my back, is quite difficult. I have seen 2 doctors one doing posterior, the other anterior. not moderated or reviewed by doctors and so you should not rely on opinions or advice given by other users in Kenneth, You saw me in your office yesterday (I am 48 years old) as I had complications following a THR of right hip anterior approach with revision 4 days later for a slipped acetabular and then last week I had a dislocated hip. My physical life is diminished. I spoke to the surgeon, he believes it may take up to 6 months to get better from this neuropraxia. The surgeon was not at the pre-op meeting, but the PA assured me it was not that big of a deal (but to me, ALL surgery is a big deal!). In the case of a worn or damaged ball and socket, artificial parts can be used to restore joint function. There is a chance that the hip will fall out of the socket, or that it will be levered out by twisting it. The rule of thumb is that recovery occurs over a 12-18 month period following injury. I wish you well. Many people seek anterior hip replacement due to the unbearable pain they feel in their hip joints. There arent any activities that you can do with a resurfaced hip that you cant do with a total hip. The posterior approach, then, is less inherently stable but may or may not require precautions. I am female and I weigh 115 pounds. I would focus on the individual doctor, not the approach that the individual choses to use, to deliver the best result. Clots can form in the leg veins after surgery. Do you agree? Do you have any advice or ballroom dancer THR stories to share? I did have a total knee replaced two years ago. 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). The surgical area of anterior hip replacement is located in the vicinity of the lateral cutaneous femoral nerve. What do you consider to be the most important factors in choosing a surgeon? I deal with major nerve damage on front of thigh, almost whole thigh. 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. This does not necessarily mean they will have more pain or take longer to get well. I am having the mini posterior done in June and my surgeon gave me the pros & cons of both. Dont let PR marketing confuse the big picture. 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. It is critical to consider the pros and cons of each option before making a decision. 4 mts later am using I also think its reasonable to look forward to returning to all of the listed activities that you enjoy. They are addictive, can cause depression, their analgesic effects are short lived and if the condition persists, you will require an increasingly higher dose to relieve the pain. Surgery carries increased risks because of these conditions, but by defining the risks and optimizing any underlying conditions, the risks can be minimized and hopefully managed. I'm hoping to read some posts post surgery. My problem isnt from a worn-down joint with no cartilage. How the soft tissues are handled and respected, the patients expectations before the surgery and the surgeons experience do. Due to security reasons we are not able to show or modify cookies from other domains. I wish you the best of luck. 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. Ann Transl Med. 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. I seem to be able to hike just fine up hill and down but not always on the flat. Understand that every total hip, no matter which approach is used to implant it, has the potential to dislocate. Other preoperative guidelines, such as using a prescribed pain medication and keeping the incision clean and dry, should also be followed by patients. I dont think one surgical approach is better or worse than the other for you to accomplish this. The second advantage of a small incision is that it makes it easier to clean and care for the hip. This is described as a posterior approach because the actual hip . I do participate in competitions and showcase presentations. I am now bracing myself for THR surgery within the next year and am wondering if there is any big advantage in trying to have this done by a surgeon who offers the customised implant, as above. Really Great. How long will my hip replacement last in your opinion? Some patients have no pain at all, which is remarkable. The information I have gathered seems to indicate the anterior approach is more inherently stable, making precautions unnecessary. SuperPATH showed better results in decreasing operation time, incision length, intraoperative blood loss, and early pain intensity. Getting in and out of cars, and turning over in bed. When it comes to revision surgery, we rely heavily on the posterior approach. A mini posterior approach is a modification of the classical posterior approach. Check to enable permanent hiding of message bar and refuse all cookies if you do not opt in. A major muscle is not cut during anterior hip replacement surgery, so pain is reduced and major muscles are not cut after the operation. And does A really have none. We want the forums to be a useful resource for our users but it is important to remember that the forums are I was told to wait 6 weeks before I resumed my exercise regiment. I'm hoping to read some posts post surgery. Does my prothesis not last as long since I am now doing a 3rd surgery? I would encourage you to discuss your expected recuperation time and specific restrictions with your surgeon. There are a few complications that can occur with anterior hip replacement surgery. Our insurance covers both. Some people may find that traditional hip replacement surgery is the best option for them, while others may prefer a minimally invasive procedure. Hip dysplasia is a very common underlying cause of hip osteoarthritis. Otherwise you will be prompted again when opening a new browser window or new a tab. 35 (2):153-62. I ski, hike (steep terrain) with a pack -about 25 pds, kayak, horse back ride, swim, water ski and bike, which is getting increasingly more difficult. It is normal to want to recover quickly and return to a very active lifestyle without pain. We are always refining and trying to make it better. THOUGHTS? It all comes down to the surgeons comfort as well as the patients. My husband tells me that I cry out in pai as I turn over during the night. Thank you for sharing with others the nerve supplements that youre finding affective. Going in for THR in July. Does it really not matter which approach I have, posterior or anterior? 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. I read about this type of mini hip replacement being done in the UK and just wondering if mini hip replacement means the same thing in the US . DAA and SuperPATH were equal in functional outcome and acetabular cup positioning. Disadvantages of the anterior approach include: The nerve which supplies sensation to the front and side of the thigh is vulnerable. disadvantages of superpath hip replacement. 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? Thank you. What you can do is keep as good an attitude as possible and keep rehabilitating your leg. Historically in my practice I performed many Bilateral THR and TKR and have backed away from that practice. Thanks, 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. I have had problems with my hip for the last several yrs. Finally, I would choose a doctor with whom you connect and whose staff is engaged and knowledgeable. Complications associated with an anterior approach hip replacement are similar to those associated with standard hip replacement surgeries. Yes, Im angry. Does this mean my body may reject the metal of the post or cup? Remember, what youre hoping to do is have a hip construct that will last 20 years or more. If your surgeon did a great job, that is something to respect. I feel that at 10 weeks with profuse denervation potentials on the quad muscles, the prognosis is not good, even at 6 months. Until now. If you have these arthritis symptoms, you should consider a hip replacement: severe hip pain that is not relieved by medication and that interferes with your work, sleep or everyday activity hip stiffness that restricts motion and makes it difficult to walk To learn more, read Here's What to Know if You Think You Need a Hip Replacement. Of note, I am a RN with 30 years of experience and took this decision very seriously. When asking a prospective surgeon about the anterior vs posterior approach he told me that it is necessary to use a smaller prosthesis which would not be as stable with the anterior approach and did not recommend it for this reason. A lot of hospitals and ambulatory surgical centers offer what's called outpatient surgery. I would avoid the metal-on-metal articulation. Hip replacement surgery is typically performed in a hospital and requires at least one night in the operating room. Dr. William Leone. Disadvantages of the anterior approach include: Although I am trained in both approaches and have trained surgeons in both approaches, I have stopped using the anterior approach because I saw my patients get well faster, bleed less, and have a more predictable result when I performed the surgery using a mini-posterior approach. Had horrible groin pain issues and opted for the antior, I knew of nothing else as I consulted with a surgeon who was trained in anterior. 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. SuperPath hip approach. I prefer reconstructing the most symptomatic side first. In 2010, more than 310,000 hip replacements were performed in the United States. Again, trust your doctor. Hi, I think researching the hospital where you will have your surgery is very important. There is also a risk of the hip joint not fusing correctly, which can lead to pain and instability. It's what compelled me to seek out different methods and post here.. You will find the surgeons will all give the pros but never the cons what ever the method. A number of patients who have undergone this procedure are able to walk unassisted the day after surgery . With that said, I would have probably just done the posterior with you if we lived in the US based exclusively on the time you take to respond! How long will my hip replacement last? There tends to be a lesser incidence of posterior instability with the anterior approach. 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. The posterior approach is used frequently again, in large part due to the fact that it is an extensile approach. Thanks so much for this information! Therapy hopefully will help any contractures and scaring within your muscles that might have developed after surgery. Other jobs, which tend to be more structured and / or more physical, may require more time off. Back to work/driving in 10 days. 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!" I wish you a full recovery. Potential Disadvantages of Anterior Hip Replacement Anterior hip replacement does have a few limitations: There may be wound healing issues Research suggests that people who undergo anterior hip replacement may be more likely to have a problem with wound healing, particularly infection. Though the duration of your hospital stay can vary, many patients having hip replacement surgery don't need to stay in the hospital very long. What are your thoughts on the use of robotics? The highly crossed linked polyethylene liners are now the gold standard in this country. Yes, you do have increase risks. Our overall findings suggested that the short-term outcomes of THA through SuperPATH were superior to DAA. There are various ways of doing a hip replacement. Consuming excessive-fibre and wholegrain meals will assist to keep you feeling full, and will be I have had to modify my activity level by cutting back greatly and also trying new activities that might not strain my hips so much(tried water walking in the deep end which cause deep pain for 2-3 days afterwards). I am just under 5 ft and weigh 185. Some surgeons will use 2 incisions, both the anterior and superior approach. We are now in a situation where we have found two extremely good surgeons and we gel with both extremely well. (I have SCD) It has now become unbearable and I am preparing for surgery. Thank you, Rita. I am a 70 yr old female with a 4grade thickness loss at acetabulum and head of femur. I wish you a full and speedy recovery. Our team of experts, doctors, and orthopedic specialists are here to share their knowledge and experience with you in order to help you make informed decisions about your health and well-being. Regardless, the overall incidence of dislocation for every approach is smaller due to use of larger femoral heads and enhanced closure techniques. After the direct anterior approach, there is generally no hip precautions required, and motion is not restricted. Everyone I know that has had both posterior and anterior surgery say not to even consider posterior. Should I look to another approach and surgeon? The most important decision you will make is choosing your surgeon. In 2014 I had to do another THA, this time on my right side. In the dark to find out about this myself. A metal or plastic implant is used to replace a damaged or diseased hipbone. Having a THR is a major undertaking and it is reasonable to expect the hip construct to function optimally for twenty and more years. What is the best hip replacement option: anterior or Posterior? I dont want a long recovery time as I am very active. That's all I know. Why would the doctor not have that at their finger tips? Not putting you on the spot, but would it be advantageous for me to drive 200 miles to have a consultation done by you? what is the super path method I've never heard of that before, superpath is just the fancy name for a smaller incision , less trauma and quicker recovery or so they say from what I have read along with more surety of the length of leg . When it comes to hip replacement surgery, the surgeons skill, the patients weight and build, and the surgeons level of experience all have an impact. An anterior-approach hip replacement necessitates a small incision in the groin area on the front side of the leg. What is SuperPath Hip Replacement? I just had mine 10/30 all I can say is be patient get lots of rest and take your pain meds way before you start to move around so that the pain want be so bad with movement.

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