disadvantages of superpath hip replacement

Im a very healthy long distance bicycle rider. Its reasonable to inquire about his or her experience using the Mako robot. Years ago, experts assumed that anterior hip replacement had lower rates of hip dislocations and nerve damage than other forms of hip replacement. Im considering this mini posterior approach. The incidence of dislocations has further decreased over the past decade with our ability to implant larger size femoral heads. Im sorry to learn that you are so disappointed with your hip replacement. I have had both hips replaced about 13 months apart, one anterior and one posterior, and there is no doubt that I would recommend anterior. Overall, however, anterior hip replacement is a safe and effective procedure with a high success rate. I am 63 years old, 54, 115 pounds. Two which are receiving the most attention are the traditional posterior approach and the direct anterior approach. My advice is to have a frank discussion with your surgeon and share these concerns. In the hands of a master, all can produce wonderful and predictable results. The most common type of total hip replacement is done in the anterior anterior part of the hip. It is also possible to have an anterior hip replacement during pregnancy. Im pleased that you will be coming in for an appointment. 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. Sometimes the pain goes away as I walk and sometimes it doesnt. I prefer spinal anesthesia when possible because fewer drugs are used and often the experience is gentler. As you can see, there are no restrictions. If you do not have a hip replacement, you will live a sedentary lifestyle and become overweight. It is possible that you will be required to avoid certain high-impact activities to protect your new hip. Its been six months since surgery, my operating doctor keeps feeding me with lets wait another month stuff. Sometimes, it simply isnt possible to accomplish. Unfortunately, injury to the lateral femoral cutaneous nerve is a common complication after the anterior approach for hip replacement. Time will tell if this generation of shorter press-fit stems fares as well. All: 1000 NE 56th Street, Did you have the surgery via Superpath method? Soon my right hip started bothering me. The mini-posterior is considered a more straightforward approach then the anterior, resulting in lesser complication rates. Its been 8 months now. I am 5 weeks out and have been doing beautifully! results, I decided to see and orthopedic doctor was advised to have THR. Advantages of an anterior approach to hip replacement A major muscle is not cut during the anterior procedure. My acyive 60 year old husband is scheduled to have Mini posterior total hip replacement in 6 weeks. Have you ever performed the Mini on a patient 1 year after major open heart surgery? Just getting your thoughts I will discuss it more with my surgeon at the pre-op meeting. As of 2020 only Dr. Leone is using the latest hip technique called the SPAIREtechnique where patients no longer have hip precautions after surgery. Dear Mary, Click to enable/disable Google reCaptcha. 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. Do you have any advice or ballroom dancer THR stories to share? As for doctors, the surgeon I had came highly recommended. Because these cookies are strictly necessary to deliver the website, refusing them will have impact how our site functions. Blog appropriate medical assistance immediately. Prior to surgery, you need to be evaluated by your primary care doctor and any other specialist who helps manage your care, so the conditions you have can be optimized. Despite the fact that this usually takes two weeks or longer, patients can return to work when they feel completely comfortable. There is a possibility that blood loss may be reduced as there is less unnecessary exposed bone surface left to bleed. 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. Thank you, Rita. There is a chance that the hip will fall out of the socket, or that it will be levered out by twisting it. It was also observed to be associated with longer surgery times. OTC nerve supplements suggested by a naturopath. We may request cookies to be set on your device. Share your concerns with your surgeon. Because of the straightforward exposure of the femur, there is less risk of femoral fracture or poor implant positioning. No, I would not tolerate the pain and immobility, if there is a reasonable way to relieve it. Download scientific diagram | (a) Components of a total hip replacement; (b) The components merged into an implant; (c) The implant as it fits into the hip [15]. And does A really have none. Its from a malformation. I am having the mini posterior done in June and my surgeon gave me the pros & cons of both. I began using the superior approach for total hip replacement in February of 2014. . In my practice, I cement an Exeter stem in a significant percentage of my patients who undergo THR . I am now 59, still in good condition but that is being compromised by lack of working out as my hips get sore from most everything I try. 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. In the case of a worn or damaged ball and socket, artificial parts can be used to restore joint function. 5. Over time, untreated hip dysplasia or hip impingement can lead to arthritis and, eventually, hip replacement surgery. I was thinking of doing that 1st, maybe April(Ill be in boot 4 weeks), and then the PTHR in either Sept or next Jan when I have free time. 1. Once youve decided, you then need to trust that he or she will take the best care of you possible to deliver the best results. It healed well but then I got major psoas pain which a cortisone shot helped. This is actually a good sign. Thank you, Lisa Blumthal. As long as you do the necessary surgeries, you will eventually break your femur, but only if you do enough. Because the patient is lying on his back during the procedure, fluoroscopy or moving x-rays are used to aid in the examination. Your article is the first Ive read in which no muscle or tendons are cut in any approach other than the direct anterior approach. There is no way that you can recover fast from having bones cut and shaped and large metal objects inserted into them. I think its reasonable to request a tour of the facility where youre considering having the procedure. We are now in a situation where we have found two extremely good surgeons and we gel with both extremely well. They may be: Cemented to the bone. Having a THR is a major undertaking and it is reasonable to expect the hip construct to function optimally for twenty and more years. SuperPath hip replacement is a differentiated total hip technique being performed by a growing number of experienced surgeons. How long will my hip replacement last in your opinion? I would stay away from narcotics. I read hip dislocation is 28% higher after a revision, is it more then 28% after 2 revisions??? We now have less-invasive techniques, better surgical methods of closing soft the tissue and more experience. 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). Your frustration is completely understandable. I would rather this not happen with my right leg when I have the THR in Jan 2017. That's all I know. Risks associated with hip replacement surgery can include: Blood clots. We need 2 cookies to store this setting. Getting in and out of cars, and turning over in bed. There tends to be a lesser incidence of posterior instability with the anterior approach. I tore my labrum at age 43 and only discovered then that I had bilateral dysplasia. What all this means for patients is a more optimum outcome and faster healing, which can reduce time interval to return to normal activities. Mine certainly have. I also think its reasonable to look forward to returning to all of the listed activities that you enjoy. This approach has a number of potential advantages, including a shorter hospital stay, less pain, and a quicker recovery. Also, the surgeon said that I would end up having one leg shorter than the other is this true? Similarly, an engaged medical team needs to be available to help with care after surgery. I spoke to the surgeon, he believes it may take up to 6 months to get better from this neuropraxia. I also think infection must be investigated and ruled out. I encourage you to do the same. I think it was sensible being careful on the other hand and I was told not to cross my legs. 2004 Apr. I had the surgery on June 22 and I am about 5 weeks post op. In my last blog post, I discussed minimally invasive surgery with regard to hip replacement. Dear Doctor Leone, Your article lacks the pros of the AMIS and the cons of min invasive posterior. The socket of the pelvis is machined into a hemisphere and a metal hemisphere is inserted into the socket. As a result, you are unable to pick up something from the floor or bend down to tie your shoes. I would then let that person decide with what approach they think they can best accomplish the surgery and deliver the best result. Not only was my recovery twice as fast with the anterior, there was very little pain in comparison. If I think you may be a candidate, I will refer you to a doctor in our area that does. It is normal to want to recover quickly and return to a very active lifestyle without pain. Surgical Techniques 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. I also regularly receive Rolfing treatments which has helped me manage pain and maintain what mobility I have. Hospitsl staff What do you consider to be the most important factors in choosing a surgeon? Most patients are able to walk the day of surgery. Please be aware that this might heavily reduce the functionality and appearance of our site. I also would learn about the track record of the surgeon and hospital where you will decide to have the surgery and what implant will be used. Historically in my practice I performed many Bilateral THR and TKR and have backed away from that practice. An anterior hip replacement is not covered by a specific credential system for orthopedic surgeons. Woke up with There are a number of different surgical ways (approaches) to access the hip joint. from publication: Current and . Testimonials I think the recovery time is the same though. 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. 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. Anterior hip replacement has the potential to cause complications and pose some risks. The second most-common injury is to the femoral nerve. Hard-on-hard bearings, such as ceramic-on-ceramic as well as metalon-metal articulations, also resulted in larger femoral heads being implanted. 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. I am an obese female and will be 62 in February. Additionally, there is a small risk of dislocation after surgery, which can be painful and may require additional surgery to correct. My main concern is that I have a tilted sacrum and a very sway back. The first is that it is a major surgery, so there is a risk of complications such as infection. What, if anything, can be done to revive femoral nerve and get my thigh muscles back in normal? 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. [QxMD MEDLINE Link]. Hello Dr Leone, My knee and foot and ankle are messed up too since leg ended up at least 3/4 shorter.I wear a shoe lift, but probably needed it sooner than I realized the shorter issue, My knee is pretty stiff and pain when I walk too much, but I deal with it, it bends good, I sleep good, no pain when I do nothing, so Im working all to do NO knee surgery, This hip was ENOUGH to last a lifetime.. Im 76 and use a lot of supplements to save knee and OA in general..I am looking at other protocols for the knee too.not insurance covered, what else is new.if its good, its out of pocket. Also, in the U.S., nearly all stems which are being implanted through the anterior approach are press-fit rather than cemented. Dr. William Leone. Everyone is. 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. Getting those studies will not change the reality that you will need THRs. and Privacy Policy and steps will be taken to remove posts identified Each is safe, effective, and capable of delivering exceptional results. I typically do hip replacement on the get anterior approach in 90% of my patients. If possible, choose a hospital that specializes in joint replacement and can back that up with excellent statistics and reputation. 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. Having diabetes and two organ transplants does significantly increase your risk for post-op infection as well as other complications. 10 users are following. Some people also tend to form scar tissue and contracture more readily than others. Im hoping to play tennis, go dancing and horseback riding once Ive healed. The earlier the recovery begins, the better chance for a more-complete recovery. 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. She provided all kinds of benefits with this approach, as faster recovery, less motion restrictions et.al. The posterior approach for hip replacement surgery is by far the most common surgical technique used in the United States and throughout the world. Clearly, he or she has earned your respect and confidence. This can be dangerous because a piece of a clot can break off and travel to the lung, heart or, rarely, the brain. Some surgeons believe that a patient who is neither obese nor overly muscular is a good candidate for anterior hip replacement surgery. THR if a MRI or Pet Scan isnt done? 4. 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. Extensive release of the posterior capsule including . My problem isnt from a worn-down joint with no cartilage. These scores are not aggregated. What are your thoughts with regard to Stem cell therapy in lieu of THR? As a result, patients can return to their normal activities much sooner than if they had had traditional hip replacement surgery. Because my husband has circulation problems in his leg and vein removed for open heart surgery last yearhis surgeon recommended the Mini posterior surgery. Hip replacement surgery is typically performed in a hospital and requires at least one night in the operating room. Hi Frances, did you have surgery posterior Superpath? Further, I would contact your insurance carrier and the hospital so you will not be surprised with any unexpected costs. Not putting you on the spot, but would it be advantageous for me to drive 200 miles to have a consultation done by you? Most receive a simple spinal with sedation. I wish you the very best, Not wanting to go through all the restrictions, I was considering anterior for my right hip, which would require not having it done locally since doctors here have been doing it for only 1 year. Most THR patients do not need significant supervised physical therapy after surgery; they simply do well when their surgery is done well. It normally takes about 3-6 weeks to resume normal household activities and about 12 weeks to resume recreational activities like bicycling or golfing. Some other methods are effective, but they are less effective for patients who leave the hospital earlier. What is your experience and take on this ? So frustrating. I am not sure that is true any more. The anterior approach has a lower incidence of sciatic nerve injury and a higher incidence of femoral nerve injury. Thanks. The vast majority of my patients have their surgeries with a simple spinal with IV sedation so they are sleeping throughout the procedure . 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. In the United States, a traditional posterior approach is the most commonly used. I had the mini posterior approach done and it gets better everyday. I had posterior and much like the superpath trussed into the jig . A hip replacement involves removing the ball (femoral head) and replacing it with a metal or ceramic prosthetic ball. Others will be empowered when they read and relate to you and/or your experience. It can lead to numbness in the thigh and, in rare cases, skin irritation due to the nerves presence. 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. Good question. I play in the 50s age group. Rather, they say Bill, please just do what you have to do and do a great job. I think researching the hospital where you will have your surgery is very important. Otherwise you will be prompted again when opening a new browser window or new a tab. Dr. Tom Miller gives you the five best options for hip replacement surgery. On July 17th, I had a left THR. While new techniques, instruments and prostheses have been developed specifically for minimally invasive surgeries, there are many well-established approaches to hip replacement. But this blog was a nice nudge toward the posterior. Surgical approach is important but its just one of many important variables. Many, many interactions and decisions go into the final result as well as someones perception of his or her result and experience. I would anticipate that you would be able to return fully to your activity once the tissues around your total hip heel. Most activities of daily living have an element of hip flexion (knee up to head), which is a safe position after the anterior total hip. 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'm hoping to read some posts post surgery. The intended interval between the front thigh muscles can be difficult to recognize and there has been an associated increase in injury to the femoral nerve or vessels. The most important decision you must make is choosing your surgeon. I have written to you to learn what are the surgical considerations for someone with shallow hip sockets like mine. Dr. William Leone. Im sorry to hear that you struggled after your first, anterior-approach THR. In the dark to find out about this myself. 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. I live in the UK so again Im afraid I wont be able to consult you personally! There are hybrids of the surgey from what I can see. The Hanna bed, general anesthesia machines, spinal setup, medications, ventilation, instruments, and their sterilization are all prerequisite. When it comes to revision surgery, we rely heavily on the posterior approach. An anterior-approach hip replacement necessitates a small incision in the groin area on the front side of the leg. It's cut off and removed through the hole. About how much does this cost? I am a South African and need to make a decision on whether my mother (69) goes for an AMIS or traditional posterior. Dr. Sigmund holds a subspecialty certificate in Orthopedic Sports Medicine. Patients can also have as little as a 3-inch incision. The traditional posterior approach is the most commonly used in the United States and throughout the world (about 70 percent). I didnt spend time on boards talking for eons about peoples outcomes.probably a good thing I didnt. Also, when a single joint is replaced versus bilateral, there is significantly less bleeding and hence a much decreased need for transfusion. Following anterior hip replacement surgery, avoid soaking in hot tub, sauna, or swimming pool immediately after surgery. A number of patients who have undergone this procedure are able to walk unassisted the day after surgery . The impingement can lead to a levering out of the ball from the socket. 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. 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. You can do anything you want after a hip replacement. Your out-of-pocket costs for your hipreplacement will be impacted by a number of . A hip replacement can greatly reduce the pain associated with arthritis of the hip, with almost all patients having complete or near-complete relief. Occasionally this even requires making a second, separate incision. It is important that these medical and cardiac conditions be optimized by your PCP and cardiologist preoperatively. I am about to have a hip replacement and would like to know what kind of limitations Ill have afterward. However, there are also some potential drawbacks to this type of surgery including a longer surgery time, a greater risk of blood loss, and a higher risk of nerve injury. We are always refining and trying to make it better. I was discharged within 24 hours. Use of the forums is subject to our Terms of Use 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. I just want to thank you for the information on this site. You helped me tremendously in my research of the track record of my HMO, now I have one more quick question to run by you. I am a 53 year old active, distance runner. He also used the term anterolateral. I wish you a full recovery. The anterolateral approach or Watson Jones approach is one of the classical hip approaches that can produce excellent results when utilized for THR. Soft tissue contractures often are associated with long-standing arthritis. There are numerous complications associated with hip replacement surgery, but blood clots in the legs and hips are two of them. I am scheduled for bilateral hip replacement at the end of August. I am going to get evals from 3 docs. I believe choosing your physician is the most important decision you can make. I know the most important decision you will make is choosing the doctor who will perform your surgery. The rule of thumb is that recovery occurs over a 12-18 month period following injury. There is also a small risk of death associated with any surgery. Do you also do arthroscope surgery? 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. The following cookies are also needed - You can choose if you want to allow them: You can read about our cookies and privacy settings in detail on our Privacy Policy Page. I wish you only the best. 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). Again, trust your doctor. He is passionate about helping his patients achieve the best possible outcome and is committed to providing the highest quality of care. Patients can also have as little as a 3-inch incision. This does not necessarily mean they will have more pain or take longer to get well.