Le has extensive experience in primary joint replacements, complex revision surgery, periprosthetic fractures, and infection management. Dear Dr. Leone, Ill be 60 at the time and Im 54 and weight about 130 lbs in fairly good shape. 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. It is possible that you will be required to avoid certain high-impact activities to protect your new hip. I would like your opinion on the stem cell injections as I am really afraid of the second surgery on the same side of my body. Do you agree? Thank you, Lisa Blumthal. His hip ball was put back in the socket and he has done beautifully since. It will help desensitize and help get your muscles working in synchrony. I saw a surgeon who does the posterior approach only and will see another on 4/14/15 who does both approaches. 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. Does my prothesis not last as long since I am now doing a 3rd surgery? Maybe someday our nations health care system will measure up to that of France, Norway, Switzerland and others, in which their governments are investing half of the GDP that we are wasting. 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. Will I still be able to do all of these things? In the front of the hip, fewer muscles are present, so the surgeon works between them instead of cutting through them and then detaching them (and then repairing them after the surgery). Welcome to Brandon Orthopedics! 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? Also, when a single joint is replaced versus bilateral, there is significantly less bleeding and hence a much decreased need for transfusion. Some patients have no pain at all, which is remarkable. We have an appointment today to discuss the plan of action. I would recommend having an honest discussion with the surgeons you are considering. Overall, however, anterior hip replacement is a safe and effective procedure with a high success rate. Stay was 2.5 days. I think it perfectly ok to discuss different approaches and ask for an opinion. 3. The surgeon will be building a construct that hopefully will last her life time and change her life profoundly. Brian Tinsley. While it is a surgery that does help many, many people, clearly you are struggling. I am very athletic and active even with many years of pain from bone on bone arthritis so I am worried about restrictions since Ill probably forget or something. 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. A hip replacement with an anterior component does not require major muscle cuts and thus patients are less likely to experience pain and require less medication. Lateral femoral cutaneous nerve injury is the most common injury incurred during an anterior approach. In the case of a worn or damaged ball and socket, artificial parts can be used to restore joint function. It is critical that the patient and the doctor consider whether the patient is a good candidate for surgery, the cost and recovery time, and the surgeons expertise. Had a total hip replacement aug 2013. I ask my patients to restrict certain positions that exceed the mechanical limits of the artificial hip for the first six weeks. Hips that are out of joint have an anterior hip replacement. Hip anatomy I have the hospital but am deciding on the surgeon and which approach is best. A hip replacement can greatly reduce the pain associated with arthritis of the hip, with almost all patients having complete or near-complete relief. 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. I ride horses, water ski and kayak. I wish you a full and uneventful recovery. The anterolateral approach or Watson Jones approach is one of the classical hip approaches that can produce excellent results when utilized for THR. It is important to understand that "less invasive" does not only refer to the incision but . Ultimately, it is important to discuss all of the available options with your doctor to determine which method of hip replacement is best for you. I also would encourage pool walking or swimming. 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 for this great informative discussion. I had the mini-posterior at MGH hospital. Your back does need to be evaluated as well. The anterior approach, as a marketing tool, has grown in popularity among surgeons. If possible, try to get in writing any verbal promises made. Overall, it sounds as if youve had an excellent result and wonderful recovery following your hip replacement. Additionally, people with certain health conditions such as diabetes or heart disease may also not be good candidates. It allows the surgeon to work between the muscles and tendons without removing them from their anchoring points on the hip or thighbone. The hope is that your nerve injury will recover with time. Rather, they say Bill, please just do what you have to do and do a great job. He strongly recommends the anterior approach as the only way to go. This allows you to resume normal daily activities quickly while also returning to normal range of motion and function. Further, I would contact your insurance carrier and the hospital so you will not be surprised with any unexpected costs. My husband has a plastic valve (done in 86) and synthetic assending aorta and triple bypass (done in 2013)very successful surgery. Types of Hip Replacement (Approach) Hip replacements can be preformed through a direct anterior approach, an anterior lateral approach, a lateral approach, a posterior approach, and a superior approach. In my practice, patients who undergo a THR using a mini posterior or posterior approach: 1. 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. Historically in my practice I performed many Bilateral THR and TKR and have backed away from that practice. My legs are very muscular and trim. Patient is a UK registered trade mark. I think there may be increased associated complications. Call (919) 781-5600 to find out if you need total shoulder replacement in Raleigh, Cary, North Raleigh, Garner, or Holly Springs. People who have anterior hip replacements tend to stop using walkers, canes, and other aids 5 to 7 days sooner than people who have conventional hip surgery. I have a tilted sacrum, sway back and a very large posterior. They may be: Cemented to the bone. The mini posterior approach works wonderfully and predictably when expertly performed. The anterior approach has a lower incidence of sciatic nerve injury and a higher incidence of femoral nerve injury. Since my acetabulum is too shallow, and other angles are off as well, how does the new cup get positioned correctly? Since a significant amount labrum has been removed, I think another attempt at arthroscopy would prove very disappointing and I would not recommend it. I already have an artificial knee that is doing great. The most common total hip replacement method is the anterior approach, which allows the surgeon to see better, more precisely place implants, and perform less invasive total hip replacement surgeries. I was released to go back to work after only 10 days. It is critical at time of surgery that an excellent range of motion be created without impingement. Also there are concerns about disruption of blood supply to femoral head with this operation. The SUPERPATH technique is a tissue-sparing procedure. Dear Jo Anna, The socket of the pelvis is machined into a hemisphere and a metal hemisphere is inserted into the socket. Once the surrounding tissues fully heal, they then act as a mechanical block to the ball to keep it from being able to jump out.. This does expose the patient to more radiation but can help with component positioning and sizing. In my experience, the restrictions (or those positions we ask our patients to avoid after surgery) have become much less limiting and are off limits for a much shorter period of time. Would you recommend treating plantar 1st? There is also a risk of the hip joint not fusing correctly, which can lead to pain and instability. The other things that can affect the op is your fitness beforehand, your attitude and your age, although you may have difficulty getting younger!! Doc says once recovered I should avoid flexion with adduction and internal rotation. The surgeon I expect to use does the Direct Anterior approach. Glad that after lots of PT and massage and medial branch block for back issues with NO!!! Dr. When the stem is placed in the femur, it still destroys the same amount of bone for implantation, regardless of which approach is used. I was discharged within 24 hours. Less tissue damage during surgery allows for a much faster recovery and no restrictions in range of motion when compared to traditional hip surgery. Even if the hip doesnt dislocate, prosthetic or soft tissue impingement is not beneficial. Anterior hip replacement has the potential to cause complications and pose some risks. Should one of these events occur during a mini-posterior procedure, they are easier to recognize and correct. 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. The hip replacement needs to correct the abnormal hip mechanics that lead to the arthritis. I would like your opinion. I spoke to the surgeon, he believes it may take up to 6 months to get better from this neuropraxia. Will meet with doctor soon but when I was finally able to really exercise after surgery I overdid it and developed plantar fasciitis. Being cared for in a hospital that specializes in joint replacement and has an extensive specialty medical staff also is key. The first is that it is a major surgery, so there is a risk of complications such as infection. I really appreciate this website. What is SuperPath hip replacement? The incision made for the operation can be as small as three inches. 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]. Can I make an appointment with you. I wish you only the best, I am unsure whether the minimal invasive posterior is available in SA. I didnt spend time on boards talking for eons about peoples outcomes.probably a good thing I didnt. J Bone Joint Surg Am. I would not recommend pushing your surgeon to use one specific approach or another. Fewer narcotic medications are administered, resulting in a better overall recovery. I would like to share my experience with both procedures. This robotic technique can assist in producing an excellent result. The impingement can lead to a levering out of the ball from the socket. If you would like a personal consultation, please contact our office at 954-489-4584 or by email at LeoneCenter@Holy-cross.com. Results of the surgery numbness in the right thigh, inability to stand on the right leg, muscle atrophy all confirmed by EMG and second orthopedic surgeon. It would be interesting to hear what you have to say Doug. I have linked back to several blog posts below that will give you more in-depth information. This means you could go home within 23 hours after surgery. I think seeing several surgeons for different opinions is good judgment. 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. My surgeon wants to use the posterior approach and indicates that I eventually should be able to play golf again. I deal with OA lower back mess so know I see most likely how all this has played into the surgery. These are some of the most grateful patients in my practice. An anterior hip replacement does not have any limitations based on comfort. What is your experience and take on this ? There are numerous complications associated with hip replacement surgery, but blood clots in the legs and hips are two of them. I have been doing ALOT of research about the different approaches to THR and looking for the absolute best surgeon. Thanks! A hip replacement is a common type of surgery where a damaged hip joint is replaced with an artificial one (known as an implant). 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. I still have a very big limp and still undergoing physical therapy. Report / Delete Reply kelly1010 nicole66881 I believe going home is very therapeutic and often safer. 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 . The most important decision you will make is choosing your surgeon. The approach planned is a frequent topic of Continued 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. There is significantly less bleeding with the mini-posterior approach, notably reducing the necessity of a blood transfusion after the surgery. It is also important to avoid any sudden movements or twisting motions. Fortunately you live in a part of the world where there are many capable orthopedic surgeons. Return to the work place is an individual decision. Click to enable/disable essential site cookies. The doctor used the posterior procedure. There are a few disadvantages to hip replacement surgery. Unfortunately, short of conservative and supportive measures, only time will tell. You can also change some of your preferences. This approach has a number of potential advantages, including a shorter hospital stay, less pain, and a quicker recovery. I would not recommend pushing your surgeon to use one specific approach or another. The big difference in anterior vs posterior hip replacement is primarily where the incision is made and how long it is. Being out of bed and moving soon after surgery adds to a patients safety and speeds the recovery. Back to work/driving in 10 days. This most often leaves the patient with an area of decreased or uncomfortable sensation or numbness over the anterolateral thigh (top, outside area of the thigh), not the entire thigh. In my experience the approach used to replace a hip does not effect how quickly a patient recovers. Also, be aware that as the nerve recovers, the smallest C fibers within the nerve recover first, which can cause a burning discomfort. I am scheduled for bilateral hip replacement at the end of August. Need to choose, then select doctor based on that decision. I am planning to have a THR this summer. [QxMD MEDLINE Link]. You can resume your active lifestyle as soon as possible thanks to a new prosthetic hip. Finally, hip replacement surgery is expensive and may not be covered by insurance. The last page is asking the participant to self score their health that day out of 100. Thanks again for this great blog! I would encourage you to discuss with your surgeon the difficulties and pain you experienced after the first surgery, and together explore if another plan can be created for a better outcome the second time around. Dr. Robert Sigmund is a board-certified orthopedic surgeon and a sports medicine physician based in St. Louis, Missouri. I spoke in person to probably 4-5 of his success patients and went with hearing from them. I take care of many individuals who have a total knee and hip replacements on the same side. Sometimes, when a surgeon is working too hard to reconstruct through a very small incision, the ends of the incision tear and the tissues are traumatized. Also congenital pulmonary hypertension (PA pressure about 52) and have hashimotos hypothyroid, and two additional auto immune issues ( alopecia and psoriasis of feet),and hypertension.
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