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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. Most of the restrictions are removed at that time, although I still advise common sense, particularly for the first three or four months. She never though mentioned an increased risk of damaging femoral cutaneous nerve or possible muscle damage that would turn into improperly heeled muscle as a result. To have your other hip replaced through a different approach is a decision you need to make with your surgeon. When it comes to revision surgery, we rely heavily on the posterior approach. If they are really happy, then you probably will be as well. Depending on the stability and range of motion observed at time of surgery, some doctors dont advise their patients to avoid any positions. Ive done PT and plan to continue working on strengthening my core and flexibility of those large muscles. I definitely didnt have any tendons or muscle cut and was cycling on the road from day 12 and back running at week 4 . A hip replacement involves removing the ball (femoral head) and replacing it with a metal or ceramic prosthetic ball. Achieving legs that feel equal in length after surgery is imperative. I am scheduled to have total hip replacement surgery in 2 weeks. If you have an abnormal anatomy or are morbidly obese, you may not be a good candidate. The anterior hip can be easily and naturally recovered by walking, simple home exercises, and isometric exercises. In my experience, people recover from femoral nerve injures more frequently and completely than from sciatic nerve injuries. Do you agree? Dear DR Leone, I am going to get evals from 3 docs. It is important that these medical and cardiac conditions be optimized by your PCP and cardiologist preoperatively. We thank you for your readership. We need 2 cookies to store this setting. Also, I am diabetic and have had two organ transplants and am extremely worried about infections, etc. Hello Dr Leone, I believe going home is very therapeutic and often safer. Felt very uninformed and left My surgeon wants to use the posterior approach and indicates that I eventually should be able to play golf again. In 2010, more than 310,000 hip replacements were performed in the United States. and Privacy Policy and steps will be taken to remove posts identified Being discharged to a rehab unit is now the exception. The surgeon will be building a construct that hopefully will last her life time and change her life profoundly. Because the mini-posterior is more straightforward, many surgeons think it provides an increased margin of safety for the patient, because the incision can easily be extended if exposure is poor, or if a fracture occurs. Do I have a risk of fractures during a posterior right hip revision due to my prior complications already? I think its always beneficial to speak to other patients who have been cared for by that physician and learn about their experiences and results. I had the posterior approach, the surgeon did not cut any muscle plus I had no pain at all after the op. I saw a surgeon who does the posterior approach only and will see another on 4/14/15 who does both approaches. I wish you only the best, Both of these are very successful ways of doing a hip replacement. 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. I am about to have a hip replacement and would like to know what kind of limitations Ill have afterward. Have you heard of something like this, and if so, is it worth it? Since these providers may collect personal data like your IP address we allow you to block them here. And does A really have none. I have dealt with my hip pain and limping for over a year, can no longer perform my daily activities, and cannot sleep well anymore. As a result of the interventions, the surgeon has a better view of the hip joint. The new femoral prosthesis and new socket . Patient aims to help the world proactively manage its healthcare, supplying evidence-based information on a wide range of medical and health topics to patients and health professionals. He treats a variety of hip, knee, and shoulder conditions, and performs hip and knee total joint replacements. Do I have a high percentage of hip dislocation after a 2nd revision done posterior way if so what is my chance of another hip dislocation even if I do the surgery again? I was released to go back to work after only 10 days. Because my husband has circulation problems in his leg and vein removed for open heart surgery last yearhis surgeon recommended the Mini posterior surgery. I would focus on the individual doctor, not the approach that the individual choses to use, to deliver the best result. 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. This is described as a posterior approach because the actual hip . Is the hospital where the surgery will be performed also top rated?. What reasons would there be to use the regular over the mini? Or are x-rays definitive for determining the exact reason for THR? I never seem to know when I am going to get hit with pain. 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. It is so important to stay focused on the outcome of your hip replacement surgery: excellent results both short- and long-term with minimal risk of injury or complication, and not lose sight of the real goal, which is to create a perfectly positioned reconstructed hip that is stable, balanced and has the best possible chance of lasting more than twenty years. Finally, in July 2013, the first SuperPATH Hip replacement in Australia was performed in Nepean Private Hospital, Sydney. Six weeks or longer is the exception. Yes, you can do very well. My strategy is to make as small an incision as possible, but one that allows for excellent exposure and reconstruction without brutalizing the tissues. What you can do is keep as good an attitude as possible and keep rehabilitating your leg. Most patients decide not to wait as long to have their contralateral hips or knees replaced after having undergone a successful surgery on the first side. I should think that all your expectations are appropriate for the activities you look forward to, especially considering youve already done so well after your knee replacement. Appalachian orthopedic surgeons perform revision surgery as well as mini-posterior and anterior approaches. They may be: Cemented to the bone. I encourage my patients to talk to other patients for whom Ive cared and learn about their experiences. We want the forums to be a useful resource for our users but it is important to remember that the forums are 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. Therapy hopefully will help any contractures and scaring within your muscles that might have developed after surgery. You should avoid sitting in low chairs, beds, or toilets. He strongly recommends the anterior approach as the only way to go. After the direct anterior approach, there is generally no hip precautions required, and motion is not restricted. Supercapsular Percutaneously-Assisted Total Hip surgery or SuperPATH surgery is a novel method of hip replacement where your surgeon can perform total hip replacement through 2-3 inch incision into the tip of the hip and without dislocating the hip or damaging the surrounding soft-tissue (muscles and tendons). Most patients are able to walk the day of surgery. Can You Use An Inversion Table With A Hip Replacement There are a number of different surgical ways (approaches) to access the hip joint. In Dr. Lawrence Dorrs opinion, doctors and hospitals should not market a specific type of surgery as the most effective. This improved quality of life will be beneficial. 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. There are potential drawbacks to anterior hip replacement. How do you ask your doctor the questions you want to ask? A hip replacement is the most common cause of complication in about 20% of cases. I would stay away from narcotics. In May of 2015, I had a Labial tear repaired. Risks of Hip Replacement Surgery The major risks include the following: Blood clot: We do reduce risk of this by using blood thinners (Enoxaparin, Aspirin or Coumadin), TED hose (compressive stockings) and compression boots on your feet to increase circulation. My doctor does the Posterior approach, he didnt say anything about the mini part. I don't think there's a one size fits all when it comes to hip surgery. The femur is prepared with the head and neck intact reducing the chance of fracture. Additionally, people with certain health conditions such as diabetes or heart disease may also not be good candidates. Would appreciate any input you might have on the auto immune issue, and weight etc. There are a few disadvantages to hip replacement surgery. Many, many interactions and decisions go into the final result as well as someones perception of his or her result and experience. The surgeon makes 2 incisions one bigger than the other on the rear side and separates the muscle and tendon to get to the hip instead of cutting the muscle and tendons to get to the hip. If your surgeon did a great job, that is something to respect. It is highly recommended that you avoid bending your hips and turning your feet together as part of hip precautions. Better luck to you all. I try not to bring up my mess but its hard when its with one 24/7. I am a 53 year old active, distance runner. Each question is scored from 1-5, with 1 being no problems and 5 being severe problems. Nerve regeneration can occur up to 18 months following injury, but the chance of full recovery decreases with delay in recovery time. I also think its reasonable to look forward to returning to all of the listed activities that you enjoy. I am a sixty five year old active male and need THR on my right hip. 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. Ive never foulnd information from any doctor or research-site but that there is always no legs-crossing, no more than 90-degrees (for the most part), and no twisting for anything but full Anterior. At the end of the day, I promise, it is not the approach but rather the person who is doing the surgery. In my last blog post, I discussed minimally invasive surgery with regard to hip replacement. I wish you a full and uneventful recovery. Posterior or Anterior? Very few metal-on-metal bearings are being placed today due to the serious potential of metallosis. It is 100 percent normal and expected to be scared before surgery. The pain is really inconsistent, one min I will be walking fine and the next it catches and is very painful, then it may go away or may not. I am temped to wait but it is getting worse. If possible and a pool available, I encourage my patients to walk and exercise in a pool and / or swim, starting at two weeks when their suture is removed. I wish you a full recovery. Complications associated with an anterior approach hip replacement are similar to those associated with standard hip replacement surgeries. After reading your articles, I have decided not to have anterior. My doctor does not do mini posterior, therefor I have a 6 incision. After a slip and fall at work 2 1/2 years ago I need a THR on my left hip. 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. Does my prothesis not last as long since I am now doing a 3rd surgery? The anterior approach typically does not violate this structure. Each surgeon approaches these issues individually. I emphasize continuing exercises at home especially walking. The main limitation after surgery is a lack of comfort. Blood-thinning medications can reduce this risk. Hips that are out of joint have an anterior hip replacement. About this injury to me. As a result of anterior hip surgery, there is little need for any special care. Surgical Techniques There is less risk of neurological injury. The other things that can affect the op is your fitness beforehand, your attitude and your age, although you may have difficulty getting younger!! If you decide to have your hip replaced in another country, I would consider carefully who would care for you if you develop a complication such as an infection, or a major medical problem like a pulmonary emboli or heart attack after surgery. I wish you well. It typically requires a 4 to 5 day hospital stay, 3 to 6 month recovery period . 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!" All have advantages and disadvantages. Fortunately, the incidence of hips dislocating after THR is very small, especially after first-time hip replacement. Im sorry to learn that you are so disappointed with your hip replacement. This approach has a number of potential advantages, including a shorter hospital stay, less pain, and a quicker recovery. With degenerative osteoarthritis of the hip developing secondary to a severe slipped capital femoral epiphysis (scfe), recreating normal hip mechanics after THR may have necessitated lengthening the first hip. The experiences will vary greatly . Each approach has advantages and disadvantages. Woke up with It helps the surgeon implant the acetabular component in a very precise position. I was out of bed walking around the evening of the surgery . What is most important is that you find a surgeon who understands the particular complexities with your problem and whom you trust. The most common type of total hip replacement is done in the anterior anterior part of the hip. Egton Medical Information Systems Limited. If possible, choose a hospital that specializes in joint replacement and can back that up with excellent statistics and reputation. Will I still be able to do the things I like to do? 5. Rather, they say Bill, please just do what you have to do and do a great job. 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. I would discuss fully your goals and concerns. The surgeon I saw said that my body structure and gait does not affect which approach would be ideal for my body. 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. I have cared for many patients over the years with significant heart and peripheral vascular disease. Orthop Clin North Am. If this occurs, the patient usually requires a total hip replacement. 2. Because the anterior hip replacement surgery is a minimally invasive procedure, no cuts are made to the muscles surrounding the hip. I am a!so told by the orthopedist who referred me that I need arthroscope on my right hip. Can I expect any problems with the bilateral it was my choice. Many of these stems have very little if any long term follow-up, although some appear to be doing well in the short term. Your symptoms still sound mechanical, positional and episodic. These can include damage to blood vessels or nerves, dislocation of the hip, and infection. An anterior hip replacement is not covered by a specific credential system for orthopedic surgeons. I prefer spinal anesthesia when possible because fewer drugs are used and often the experience is gentler. I will let you in on something personal. I had my hip scoped which bought me 8 years, but need a THR now. 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. Each approach you list has advantages and disadvantages. Also on MRI there was a cyst (good size). 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. Clearly, he or she has earned your respect and confidence. Currently we use standard ways, called either posterior or direct lateral approach. 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.