2021 May 20;16(1):324 . With the ease of movements during pregnancy, you will be able to move around more freely. The doctor has scheduled me for total hip replacement in two weeks and he uses the Posterior approach, he didnt say anything about the mini part. I think there may be increased associated complications. Surgical Approaches To Hip Joint Dr. Apoorv Jain D'Ortho, DNB Ortho . It also keeps the surrounding muscles and tendons in place to reduce the risk of post-op pain and nerve damage. I am an obese female and will be 62 in February. Hip implants are medical devices intended to restore mobility and relieve pain usually associated with arthritis and other hip diseases or injuries. Thank you for sharing with others the nerve supplements that youre finding affective. Fortunately, you have already experienced a THR and have done well. I think its reasonable to request a tour of the facility where youre considering having the procedure. You should consult with your doctor before deciding to have an anterior total hip replacement. You are to be commended for taking the time to answer our questions. 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!" 4. Hips that are out of joint have an anterior hip replacement. I had the posterior approach, the surgeon did not cut any muscle plus I had no pain at all after the op. This too will lower your anxiety and improve your experience. 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. Im now 6 weeks out and doing good. 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. In another day I was able to take short walks without any limping, etc.. I would focus on the individual doctor, not the approach that the individual choses to use, to deliver the best result. Dear Dr. Leone: In addition, patients prefer the anterior approach due to the absence of pressure on the Femoral nerve in the anterior approach. The surgical technique for a SUPERPATH Hip Replacement was developed as an advancement to traditional total hip replacement. Does this mean my body may reject the metal of the post or cup? This often leads to a less than optimal component position. They may have a certain cut-off criteria (for example, a BMI of less than 35). Its been my experience that femoral nerves tend to recover more readily than sciatic nerves. Its interesting that when we critically analyze all the variables that ultimately make up the experience that one person has compared with another, or that one person experiences on one side versus the other, we come to recognize its not so straightforward. Many in business or who own their own businesses will stay home for only one week and then return to their work place because they are bored and would rather be productive and busy. I would not change the position of the components. I feel good now and walking good now but feel so disabled as I dont know if my hip will dislocate again.I am sorry if you may have responded to some of these questions already as it is so much information to absorb and I dont want to make a wrong decision again. Thanks so much for this information! The surgery is more difficult and more exacting . Patients mobilize the day of surgery and typically go home the next day. When compared to the anterior approach to hip replacement, which is typically more painful, there are several advantages to recovering from an anterior approach, including the fact that you will not be required to follow any specific anterior hip replacement precautions, such as bending or crossing your leg. Better luck to you all. It is important to consider the SuperpathTM technique if you are considering a hip replacement. [QxMD MEDLINE Link]. In a posterior hip replacement, the procedure is done on the side of the hip. 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. This allows you to resume normal daily activities quickly while also returning to normal range of motion and function. A hip replacement can be delayed until it is absolutely necessary if the replacement parts can fail over time. This is used when the cartilage in the hip is severely damaged by osteoarthritis or other conditions. Get Directions, Phone: 954-489-4575 Thank-you. Consult your doctor to determine if joint replacement surgery is right for you. 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. I would encourage you to discuss your concerns with you surgeon. The hip joint needs to be replaced again when it no longer works properly because of a revision surgery. Historically, higher dislocation rates were reported with the posterior approach, but it still was used for its many other advantages. These can include damage to blood vessels or nerves, dislocation of the hip, and infection. I am temped to wait but it is getting worse. So frustrating. Mar 13, 2013. The femoral nerve functions to extend the knee and also is responsible for sensations over the anterior and medial aspects of the thigh, medial shin, and arch of the foot. I have had problems with my hip for the last several yrs. Due to security reasons we are not able to show or modify cookies from other domains. 3 years ago, SuperPath brings some of the best benefits such as; earlier ambulation, no loss of strength, quicker recovery, less pain, decreased dislocation risk, and easier exposure for future revision surgery. The art of surgery should mimic a well rehearsed ballet or symphony. Personally I had the posterior approach and cannot see how I could have recovered any faster . In my experience, people recover from femoral nerve injures more frequently and completely than from sciatic nerve injuries. disadvantages of superpath hip replacement. I deal with major nerve damage on front of thigh, almost whole thigh. You can check these in your browser security settings. He is the founder and main author of brandonorthopedics.com, a website that offers valuable resources, tips, and advice for patients looking to learn more about orthopedic treatments and physiotherapy. results, I decided to see and orthopedic doctor was advised to have THR. Thigh feels so Heavy and I massage that area a lot. Adductors refer to a group of muscles that insert into the medial (inner) upper femur and often become contracted with an arthritic hip. I am seriously looking at the infection rate at each facility. Pain Management If they did develop five months post-op, then you have to consider that it could be a manifestation of back pathology compromising a nerve root. I dont know what happens on that tablewas he in a hurry on Friday afternoon. As of 2020 only Dr. Leone is using the latest hip technique called the SPAIREtechnique where patients no longer have hip precautions after surgery. Finally, hip replacement surgery is expensive and may not be covered by insurance. No, I would not tolerate the pain and immobility, if there is a reasonable way to relieve it. General comments will be answered in as timely a manner as possible. It sounds like he did fabulous job. I would like your opinion. After reading a few articles on anterior vs posterior including yours, I know now that his decision to use the posterior approach is the best one for me! Consuming excessive-fibre and wholegrain meals will assist to keep you feeling full, and will be Just because hardware in your foot needed to be removed after repairing what sounds like a calcaneal (heel) fracture, absolutely does not mean that your body rejected the metal / hardware or that your body will reject the prosthesis your surgeon will implant to reconstruct your hip. Fewer narcotic medications are administered, resulting in a better overall recovery. The impingement can be between the metal neck of the stem and edge of the cup or between soft tissues. The surgical area of anterior hip replacement is located in the vicinity of the lateral cutaneous femoral nerve. It would be interesting to hear what you have to say Doug. The most important decision you will make is choosing your surgeon. Can you explain it to me as he didnt go into detail. I had an MRI by a different hip doctor (a preservationist) who diagnosed me with a birth defect (hip dysplasia). Does the mini posterior hip replacement conserve more femur and allow for future surgeries if needed ? Reconstructing the opposite hip hopefully will result in legs that feel more equal. Fax: 954-489-4584 Fortunately, many folks who experience back symptoms before THR report improvement or resolution after. I was told to wait 6 weeks before I resumed my exercise regiment. In some individuals, it takes much more force and dissection in order to accomplish this (typically, there is significantly more bleeding from an anterior approach compared to a mini-posterior approach). 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. Dear Mary, Can You Use An Inversion Table With A Hip Replacement The pain in my hip is strange in that I can hike uphill and down hill, bike and X-country ski but have a very hard time walking on the flat, especially after sitting for awhile or getting out of bed. 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. Read our editorial policy. Share your concerns with your surgeon. Disadvantages of the anterior approach include: The nerve which supplies sensation to the front and side of the thigh is vulnerable. After reading your blog Im thankful he suggested this approach. My worry is that I will end up with one leg shorter than the other. These positions include crossing your legs, bending your hip more than 90 degrees, or lying on your stomach. Part of those possibilities includes a better and more comfortable sex life. I have a tilted sacrum, sway back and a very large posterior. Still going to rehab to reduce stiffness and increase strength but I am in better shape now than before surgery. It exploits the inter-muscular interval between the tensor fascia lata and the gluteus medius. I am a sixty five year old active male and need THR on my right hip. 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 was out of bed walking around the evening of the surgery . In the hands of a master, all can produce wonderful and predictable results. July 2013 my left hip was scoped for a labral repair. If I can put you on the spot. I worry that replacing it with a differently configured socket could make things worse rather than helping. Because the patient is lying on his back during the procedure, fluoroscopy or moving x-rays are used to aid in the examination. 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. What has changed the most in my career, once again in a very positive way, is how quickly patients start walking (day of surgery), and go home and return to their active lives after THR, as compared with just a few years ago.