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I wish your patient well. I deal with OA lower back mess so know I see most likely how all this has played into the surgery. Mini posterior refers to the approach or tissue interval the surgeon uses to implant the Total Hip. Despite the fact that this usually takes two weeks or longer, patients can return to work when they feel completely comfortable. Ultimately, you and your husband need to choose the surgeon who you both feel will provide the possible best care, based on reputation and your personal comfort level. Most patients after a bilateral procedure would not go home but rather a rehab unit. (Of course, I do.) 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. Not sure exactly what that means. Report / Delete Reply kelly1010 nicole66881 posterior surgery . I ask my patients to restrict certain positions that exceed the mechanical limits of the artificial hip for the first six weeks. I am 56 now and find that physical therapy and chiropractic care dont seem to be helping anymore. Are expected to be out of bed (hips and knees patients) the afternoon of their surgery and at least taking a few steps if not walking. What is the best hip replacement option: anterior or Posterior? Our insurance covers both. (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. Therapy is often appropriate for stretching, strengthening and electrical stimulation which helps maintain the motor end plates, structures on the muscles that the nerve branches must re-innervate. William Leone. The hip replacement needs to correct the abnormal hip mechanics that lead to the arthritis. 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). Dr. Robert Sigmund is a board-certified orthopedic surgeon and a sports medicine physician based in St. Louis, Missouri. daniel neeleman net worth . 3. My right leg is already a bit longer than the left. I am so sorry to learn that you have had such a bad experience after THR. Disadvantages of the anterior approach include: The nerve which supplies sensation to the front and side of the thigh is vulnerable. If the tissues are traumatized and / or the final components are not optimally positioned, then it certainly is not an advantage. Third, the procedure is shorter in length and requires less hospital stay than traditional hip replacement surgery. Pam. I am a sixty five year old active male and need THR on my right hip. I had an anterior right hip replacement in late 2010, I was 72. 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 am concerned that I may have a pinched nerve and that that is what is causing all this pai as the pain is severe only in certain positions but when I am tired I also have a throbbing pain in the sciatic region.talk about the golden yearsI thank you from the bottom of my heart for the kindness and caring that you do in answering all these questions. What is your experience and take on this ? Most receive a simple spinal with sedation. I think it perfectly ok to discuss different approaches and ask for an opinion. 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. A hip replacement is the most common cause of complication in about 20% of cases. Thigh feels so Heavy and I massage that area a lot. My surgeon does the SuperPath method. Blood clots or bleeding. Brian Tinsley. Because visualizing the femur is easier, an experienced surgeon can choose the most appropriate femoral implant rather than just the one that is easiest to implant, taking into account the patients bone quality, activity level and age. What all this means for patients is a more optimum outcome and faster healing, which can reduce time interval to return to normal activities. Finally, in July 2013, the first SuperPATH Hip replacement in Australia was performed in Nepean Private Hospital, Sydney. A hip replacement can be delayed until it is absolutely necessary if the replacement parts can fail over time. Click to enable/disable _ga - Google Analytics Cookie. Cant afford a dislocation or other complications cause Im sole caregiver for severely handicapped son. The activity that I wish to have the most success with after the surgery is ballroom dancing. I think there may be increased associated complications. crackling noise/pain, cannot bend them or kneel in church or get on the floor to do exercises, I am very afraid to ending up in a wheelchair or having to use a walker the rest of my life.I am a very active 65 year old, and very, very worried about the hip surgery. I would suggest seeking out doctors who specialize in hip replacement surgery rather than general orthopedics. My surgeon has told me I will need PT 3 times a week for 6-12 weeks is this too long? I came home with crutches, abandoned them at the front door and have not used them since. The second most-common injury is to the femoral nerve. My doctor does the Posterior approach, he didnt say anything about the mini part. About how much does this cost? I have seen a number of patients who were reconstructed with the anterior approach who developed painful anterior scarring after the procedure. The particular surgeon who did your hip is also uniquely qualified to advise you with regard to the postoperative stability of your particular hip, because he or she physically tested your hip intra-operatively. I have a good surgeon (same one as last time) but I dont know how he would feel about my asking if a mini posterior (or posterior) procedure be carried out, so as to preserve as much strength in my right leg as I now have.Do as many muscles need to be cut in the mini posterior procedure? 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 . I would anticipate that you would be able to return fully to your activity once the tissues around your total hip heel. I know the most important decision you will make is choosing the doctor who will perform your surgery. Operating through too small an incision and not releasing tissue that would improve exposure and result in a more balanced joint in my opinion does a disservice. Understand that every total hip, no matter which approach is used to implant it, has the potential to dislocate. Fortunately, many folks who experience back symptoms before THR report improvement or resolution after. Can you explain this approach? The most common reason or diagnosis that leads me to replace the hips of young women is hip dysplasia. A recent article published by the Journal of Bone and Joint Surgery has demonstrated that the direct anterior hip replacement has more blood loss, a higher risk of intraoperative fractures, an overall higher complication rate and no difference in outcomes versus other techniques. I read about this type of mini hip replacement being done in the UK and just wondering if mini hip replacement means the same thing in the US . You should consult with your doctor before deciding to have an anterior total hip replacement. Dear Mary, Can you suggest any pain medication that would not interfere with anti rejection drugs? A long surgery time, on the other hand, was also associated with DAA. Ken. I had good results into 5th month post op and then everything went downhill. All have advantages and disadvantages. Im considering this mini posterior approach. I have had to modify my activity level by cutting back greatly and also trying new activities that might not strain my hips so much(tried water walking in the deep end which cause deep pain for 2-3 days afterwards). In comparison to traditional methods, anterior approaches to the hip joint are more effective. I have never operated on another surgeon who asked me to make as small an incision as possible or use the minimally invasive approach. The doctor is planning a traditional posterior. (I have SCD) It has now become unbearable and I am preparing for surgery. In my last blog post, I discussed minimally invasive surgery with regard to hip replacement. If these values are elevated, further investigation with hip aspiration should be considered. For example, the stability of the components could have been achieved initially, but then proved inadequate so you developed either a loose cup and/or a loose stem. Try our Symptom Checker Got any other symptoms? What are your thoughts on the use of robotics? Its been my experience that femoral nerves tend to recover more readily than sciatic nerves. I am unsure whether the minimal invasive posterior is available in SA. 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. 4 mts later am using Other combinations of materials have advantages and disadvantages (for instance, some researchers believe that ceramic-on-ceramic types may be more durable, but they have also been known to make squeaking and popping sounds.) 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 risk of revision surgery after a posterior hip replacement is the most serious concern. Patients can also have as little as a 3-inch incision. Time will tell if this generation of shorter press-fit stems fares as well. The doc I saw yesterday said 4 weeks. Sometimes the pain goes away as I walk and sometimes it doesnt. 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. I walk a lot in my job and bend lots (work with children) and sitting causes pain due to impingement. 2 x week. Thank you, Lisa Blumthal. I am scheduled for bilateral hip replacement at the end of August. What is most important is that you find a surgeon who understands the particular complexities with your problem and whom you trust. It is 100 percent normal and expected to be scared before surgery. I wish you the best of luck, Some hospitals and surgery centers are promoting one method of hip replacement over another. I have seen 2 doctors one doing posterior, the other anterior. Gary. Hip replacement surgery is less painful than arthritis or fracture-related pain. Also, some body structures or anatomy makes approaching a hip anteriorly much more difficult than others. 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. Specific protocols, therapy and what positions you will be asked to avoid after surgery and for how long will be directed by your surgeon. 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. All of these releases may be necessary as part of the surgery and patients do well. I saw a surgeon who does the posterior approach only and will see another on 4/14/15 who does both approaches. Hello Dr. If your surgeon did a great job, that is something to respect. Also had Traditional Hip Replacement - Traditional surgery requires a large incision of 10 to 12 inches and detachment of muscles from the hip. This is actually a good sign. The bigger the ball, the bigger the ROM without impingement and the bigger the jumping distance that would be required for the hip to dislocate. The questions youre asking are 100 percent appropriate. The posterior approach is used by a small percentage of people.