On July 17th, I had a left THR. I am wondering if having mild hip dysplasia is a factor in which approach is used. But I am now in chronic low grade pain thats getting worse and dont know what I should do. It does sound as if proceeding with a THR is appropriate, since your attempt to repair the joint arthroscopically did not pan out. I also recommend that you look at the track record and reputation of the hospital where the surgery will be performed, especially considering the underlying cardiac and vascular issues. SuperPath hip approach. When performing anterior anterior reconstruction, these patients frequently have very short stems that are inserted into the bone. However disadvantages include the inability to adjust for leg length differences and a relatively high risk of femoral neck fracture. There has been an increase in the range of motion. 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 . Super path appears to come with it's hazards due to bone sawing rather than dislocation of the hip to be replaced, making revision much more difficult if issues occur later down the line. While it is a surgery that does help many, many people, clearly you are struggling. The healing and maturation of this tissue takes time. Tina, which procedure did you have? My advice is to have a frank discussion with your surgeon and share these concerns. The most common reason or diagnosis that leads me to replace the hips of young women is hip dysplasia. I would consider talking to other patients who had their hips replaced by that physician and learn about their experiences. Dear Dr. Leone: The mini-posterior approach involves separating the muscle fibers of the large buttock muscle located at the side and the back of the hip. Walking is the best exercise. Dr. William Leone. Behavior. Thank you, Lisa Blumthal. The posterior approach is used by a small percentage of people. We provide you with a list of stored cookies on your computer in our domain so you can check what we stored. Hip replacement surgery is typically performed in a hospital and requires at least one night in the operating room. surgeons certainly do not go out of their way to cut anything, they move stuff about, if tendons do get damaged, it's more likely from the anterior approach as they have less 'sight' of the procedure due to the smaller incision. I am so sorry to learn that you are struggling. Also, I am diabetic and have had two organ transplants and am extremely worried about infections, etc. Choose your surgeon and not the approach or prosthesis. In has been my experience in life that if others are happy and had a good experience then that speaks strongly to me, if I were to do the same thing. I absolutely would not insist on minimally invasive surgery and a small incision, especially considering your mom is short, obese and has osteoporosis. What is most important is that the surgery is expertly done, that the tissues are not brutalized, and that the surgeon can see what he or she is doing. Surgeons do not cut across muscles. The anterior approach exploits an interval between muscles that cross the front of your hip and thigh. William Leone. I wish you a full and satisfactory recovery. 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. Following the anterior approach, we provide you with a number of precautions and positions that you should avoid if you are in danger of being discomfited. Gary. 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. Still going to rehab to reduce stiffness and increase strength but I am in better shape now than before surgery. Overall, however, anterior hip replacement is a safe and effective procedure with a high success rate. I wish you the best of luck, No i just had the posterior method which has a larger incision. Also, if a surgeon knows in advance that a certain range of motion is desired, can they provide some adjustment in surgery to help accommodate that desired movement? Further, rehab after hip arthroscopy often requires partial weight bearing on the operative side and that would be difficult with newly operated THR on contralateral side. I find it curious that you report having a good result for the first five months after your surgery as this suggests that the surgery was done for the right indication, i.e., you did well and were pleased for the first five months after THR. Now 1 yr later dont have buckling/giving out but a lot of pain is there and after walking around, after about 20 minutes it hurts to lift leg forward, also good hip starting to hurt. There is a possibility that blood loss may be reduced as there is less unnecessary exposed bone surface left to bleed. Are my findings that posterior approach in my situation would have been more appropriate? I would suggest seeking out doctors who specialize in hip replacement surgery rather than general orthopedics. I am a competitive tennis player in my age division. Each approach has advantages and disadvantages. A number of patients who have undergone this procedure are able to walk unassisted the day after surgery . I find that patients who are well informed and know what to expect prior to surgery get well even faster. Also, because technically it is easier, many patients are being reconstructed with very short stems which are press fit into the bone during an anterior approach. Also on MRI there was a cyst (good size). Would appreciate any input you might have on the auto immune issue, and weight etc. Click to enable/disable _ga - Google Analytics Cookie. Everyone I know that has had both posterior and anterior surgery say not to even consider posterior. Also, in the U.S., nearly all stems which are being implanted through the anterior approach are press-fit rather than cemented. I would look for a surgeon who is busy, has a strong track record and who practices at a hospital with a stellar reputation and where many joint replacement surgeries are done. Country. There are many different quality implants (just like surgeons and hospitals). Very slow recovery. You can be successful by staying healthy by sticking to less pain. Always speak to your doctor before acting and in cases of emergency seek I was told the joint lubricant had migrated into the hip bone creating the cyst, There is effusion in the joint and stress areas. Bleeding at the operative site can occur as a result of an anesthesia reaction, such as an allergic reaction. The most important decision you will make is choosing your surgeon. I try not to bring up my mess but its hard when its with one 24/7. I think it was sensible being careful on the other hand and I was told not to cross my legs. 2. Does this mean my body may reject the metal of the post or cup? The risk of revision surgery after a posterior hip replacement is the most serious concern. Two which are receiving the most attention are the traditional posterior approach and the direct anterior approach. The doctor is planning a traditional posterior. 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. Traditional Hip Replacement - Traditional surgery requires a large incision of 10 to 12 inches and detachment of muscles from the hip. Do you also do arthroscope surgery? (tho I am sure I asked about it ahead of time), I believe you are having trouble finding definitive answers and recommendations because every surgeon has his or her own recipe and experience and also the medical recommendations keep changing. Many also mate this with a ceramic femoral head. A less stringent set of precautions is required with the anterior approach. I do not have dials and no one seems to know where the neuropathy stems from. I think speaking to a patient with whom you can relate and who has been treated by the physician youre considering also is invaluable. Because the gluteus medius and minimus lie over the anterior capsule and insert into the greater trochanter, it does require greater trochanter osteotomy or more commonly a partial elevation of these muscles from their insertion, which can lead to damage. 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. 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. The main limitation after surgery is a lack of comfort. It is important that you find a doctor who is experienced in caring for people with complex issues. I did have numerous blood tests, MRI of knee and hip, total body scan with radio active injection, X-ray knee and hip etc. Thanks for any feedback. I'm scheduled for THR on the 22nd. In addition, patients prefer the anterior approach due to the absence of pressure on the Femoral nerve in the anterior approach. The highly crossed linked polyethylene liners are now the gold standard in this country. Because the patient is lying on his back during the procedure, fluoroscopy or moving x-rays are used to aid in the examination. Very few metal-on-metal bearings are being placed today due to the serious potential of metallosis. Does either procedure in this discussion present restrictions or advantages for this sort of movement? Should I be though? The bone isn't dislocated in surgery. Very strange If your X-rays reveal that you already have bone on bone due to osteoarthritis, then you typically dont need either an MRI or Pet Scan, unless another diagnosis is suspected. I am a 53 year old active, distance runner. I would also like to know about the customized implant, as I havent yet heard much about it. Will I still be able to do the things I like to do? There is also a small risk of death associated with any surgery. Thank-you. 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. We thank you for your readership. When a patient feels better, they can return to work almost immediately, though it usually takes two weeks or longer. My main concern is that I have a tilted sacrum and a very sway back.
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