disadvantages of superpath hip replacement

Please do not take this as an attack, but your article seems biased on your experience (great results with min. Third, the procedure is shorter in length and requires less hospital stay than traditional hip replacement surgery. I have never operated on another surgeon who asked me to make as small an incision as possible or use the minimally invasive approach. No feeling in my leg and no movement My doctor does not do mini posterior, therefor I have a 6 incision. They are encouraged to be very active and most stop using a cane, can drive their cars and are exercising in the pool, just two weeks after surgery. Dr. William Leone. Studying a hospital and physicians track record before you commit is important. 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. The incision made for the operation can be as small as three inches. No Muscles Cut is for billboards. The anterior approach, as opposed to the lateral or posterior approach, uses a small incision in the front of the hip. Doc, Ive worked out and been physically active forever running, biking, skating, etc. Since my acetabulum is too shallow, and other angles are off as well, how does the new cup get positioned correctly? I have been in pain for about a year and first though it was a back issue and it has limited my ability to stay as active as I would like. Im sorry to hear that you struggled after your first, anterior-approach THR. This means you could go home within 23 hours after surgery. If you have these arthritis symptoms, you should consider a hip replacement: severe hip pain that is not relieved by medication and that interferes with your work, sleep or everyday activity hip stiffness that restricts motion and makes it difficult to walk To learn more, read Here's What to Know if You Think You Need a Hip Replacement. Further, I would contact your insurance carrier and the hospital so you will not be surprised with any unexpected costs. Changes will take effect once you reload the page. Choose your surgeon and not the approach or prosthesis. Other preoperative guidelines, such as using a prescribed pain medication and keeping the incision clean and dry, should also be followed by patients. Fitness going into surgery and speed of recovery seems to be a common theme though. Blood-thinning medications can reduce this risk. 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. My right leg is already a bit longer than the left. There is also a risk of the hip joint not fusing correctly, which can lead to pain and instability. As of 2020 only Dr. Leone is using the latest hip technique called the SPAIREtechnique where patients no longer have hip precautions after surgery. Also many folks develop peripheral neuropathy in their lower legs, which also becomes more common with age. Fax: 954-489-4584 My recommendation is to go back to your surgeon and share your concerns and issues to see if a fresh and thorough reevaluation wont help define the problem(s) and solutions. I deal with major nerve damage on front of thigh, almost whole thigh. 1.2. Thanks. Felt very uninformed and left I suspect there is significant underlying osteoarthritis related to your labral pathology. Email us. Can you explain it to me as he didnt go into detail. I am looking at how many hips they have done and where they are doing them. A hip replacement can be delayed until it is absolutely necessary if the replacement parts can fail over time. Thanks for any feedback. The most important variable is how quickly the person is motivated to return to work. I am about 5 6 and 185 lbs, age 58, he did not think the weight was an issues. By continuing to browse the site, you are agreeing to our use of cookies. It is not acceptable to lean forward while sitting down or standing up, and it is not acceptable to bend past 90 degrees (as shown in the angle in the letter L). Clearly, yours was. Many of these stems have very little if any long term follow-up, although some appear to be doing well in the short term. This site uses cookies. Dear Mary, I, too, am struggling which approach to have. SuperPath approach is the least invasive due in part to the minimal amount of tissue damage. Which is the best? The art of surgery should mimic a well rehearsed ballet or symphony. I do not have dials and no one seems to know where the neuropathy stems from. The surgeon will be building a construct that hopefully will last her life time and change her life profoundly. This technique is also referred to as the . I don't think there's a one size fits all when it comes to hip surgery. Thank you for sharing. Over the years, these precautions and the length of time to adhere to these limits have been challenged both by clinicians and patients. Possibly, its secondary to an altered gait pattern or hip mechanics. In May of 2015, I had a Labial tear repaired. Everything does point to posterior being the better of the two, but first i wasnt given a choice, and much easier said to shop for surgeon, than to do it, when only one in this area takes my insurance. Some surgeons believe that a patient who is neither obese nor overly muscular is a good candidate for anterior hip replacement surgery. A hip replacement is a common type of surgery where a damaged hip joint is replaced with an artificial one (known as an implant). A mini posterior approach is a modification of the classical posterior approach. The most common type of total hip replacement is done in the anterior anterior part of the hip. Glazener C, Fraser C, Hutchison J, Vale L. Single mini-incision total hip replacement for the management of arthritic disease of the hip: a systematic review and meta-analysis of randomized controlled trials. Very important with both the traditional posterior and the mini-posterior approaches, if the surgeon is not able to visualize critical structure adequately, or if a problem were to arise such as a fracture, then either approach can easily be adjusted. But this will always prompt you to accept/refuse cookies when revisiting our site. I think it perfectly ok to discuss different approaches and ask for an opinion. Also I have read that there is a sharp learning curve that must take place in order to do the direct anterior approach. I needed no physical therapy at all. Do you have any advice or ballroom dancer THR stories to share? What is the best hip replacement option: anterior or Posterior? Thank you. 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. Similarly, an engaged medical team needs to be available to help with care after surgery. I would consider talking to other patients who had their hips replaced by that physician and learn about their experiences. Having diabetes and two organ transplants does significantly increase your risk for post-op infection as well as other complications. A ball and socket are used to connect the new joint to the thigh bone (femoral bone), which is made of metal, plastic, and ceramic. I have written to you to learn what are the surgical considerations for someone with shallow hip sockets like mine. Three Cons of Hip Replacement Although total hip replacement is deemed a very safe procedure, there are associated risks that patients need to be made aware of before surgery. My surgeon uses the posterior approach. What is most important is choosing your surgeon. What are the risks involved? The femoral prosthesis is inserted into the hollow part of the femoral shaft. 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. Its been my experience that femoral nerves tend to recover more readily than sciatic nerves. I am not sure that is true any more. Driving hurts too. We are always refining and trying to make it better. These scores are not aggregated. For the prevention, diagnosis, and treatment of hip pain and other problems affecting your hips, call Advanced Sports Medicine Center today at (941) 957-1500. We thank you for your readership. from publication: Current and . The surgeon I went to said he does THR using a lateral approach. These other conditions need to be defined and hopefully ruled out as the primary source of pain. 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. Introduction The surgeon I expect to use does the Direct Anterior approach. The anterolateral approach or Watson Jones approach is one of the classical hip approaches that can produce excellent results when utilized for THR. but it was more torn than they thought and they had to cut out about 1/4 of it. The mini-posterior is considered a more straightforward approach then the anterior, resulting in lesser complication rates. 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. Many wonderful physicians are part of various HMO panels. They thought surgery to repair it would give me about 5 yrs. Call (919) 781-5600 to find out if you need total shoulder replacement in Raleigh, Cary, North Raleigh, Garner, or Holly Springs. not moderated or reviewed by doctors and so you should not rely on opinions or advice given by other users in Its reasonable to inquire about his or her experience using the Mako robot. (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. So frustrating. 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 Dr. Leone, Why would the doctor not have that at their finger tips? I saw a hip surgeon last year for an opinion, but because I had almost no arthritis on the x-ray he said he saw no need for surgery. These cookies are strictly necessary to provide you with services available through our website and to use some of its features. The first is that it is a major surgery, so there is a risk of complications such as infection. Please be aware that this might heavily reduce the functionality and appearance of our site. Long recovery but all is well. Original Medicare (Part A and Part B) will typically cover hip replacement surgery if it's medically necessary. Really Great. 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. Two which are receiving the most attention are the traditional posterior approach and the direct anterior approach. It seems, however, that at this time point, patients who have received resurfacings do as well or better than similar patients who have received total hip replacements. 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. Technologies, The Leone Center 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. I am allergic to narcotics . 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. J Orthop Surg Res. The hip is replaced without the need for surgery to dislocate the joint. It is also possible to have an anterior hip replacement during pregnancy. It is also important to avoid any sudden movements or twisting motions. I never seem to know when I am going to get hit with pain. I am suffering from a severe range of motion where I cant put my left sock on or tie my left shoe, I can barely get in and out of low cars and sitting up at a table hurts too! Dear Doctor Leone, Kenneth, You saw me in your office yesterday (I am 48 years old) as I had complications following a THR of right hip anterior approach with revision 4 days later for a slipped acetabular and then last week I had a dislocated hip. I have congenital hip dysplasia which has gradually caused more pain as Ive gotten older. This is actually a good sign. The pain I get is in the groin and a sharp pain in the buttocks, that feels like muscle pain. I had the mini posterior approach done and it gets better everyday. I am so sorry to learn that you are struggling. When done well, your body does well with this technology. My main concern is that I have a tilted sacrum and a very sway back. Posted My second question relates to something you mentioned earlier regarding checking the published track record of the surgical team if I use an HMO, how do I find that information, and how do I know it hasnt been skewed to give more favorable results (lying with statistics)? Extensive release of the posterior capsule including . This surgical procedure is performed with a patient lying on their side, and a surgical incision made along the outside of the hip. 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. Otherwise you will be prompted again when opening a new browser window or new a tab. I havent dropped in here for a while but here I am almost 5 yrs post op Anterior and Femoral Nerve Damage is very alivewhole thigh is numb, IT band is still very sore and numb. Patient Resources Many also mate this with a ceramic femoral head. Hip replacements might keep you out of action for a considerable period. I would rather this not happen with my right leg when I have the THR in Jan 2017. I can still do 30-45 mile rides, but I need to take something before each ride, because of the undone left hip. Some people may find that traditional hip replacement surgery is the best option for them, while others may prefer a minimally invasive procedure. Again, trust your doctor. Thank you. I would encourage you to discuss your concerns with you surgeon. I have the surgery planned, but then another medical professional warned me that the posterior approach will limit my twisting range of motion and prevent me from playing golf. Superpath total hip replacement animation. These are all realistic goals. If you would like a personal consultation, please contact our office at 954-489-4584 or by email at LeoneCenter@Holy-cross.com. I have insurance with very high deductible and I am scared of the debts I might incur afterwards too ( where I am planning to do it I might not have to pay any money). No, I would not tolerate the pain and immobility, if there is a reasonable way to relieve it. We can help you make the best decision for your knee replacement, and our friendly staff is available to answer any questions you may have. 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. I am just under 5 ft and weigh 185. Personally, I would not gamble with my health. I am planning to have a THR this summer. Update what hes cutting is the adductor so my question is the same is this just a normal part of some THRs? A THR is in my future. This often leads to a less than optimal component position. I also think its reasonable to look forward to returning to all of the listed activities that you enjoy. I sit on a cushion in the car to lift me up. 2 x week. In the United States, a traditional posterior approach is the most commonly used. Finding the right surgeon is critical, because your care is about so much more than just fixing your hip. Total hip replacement is a step-by-step surgery to replace the hip socket and the ball at the top of the thighbone (femur). Because the patient is lying on his back, it facilitates using a fluoroscope or moving x-ray throughout the procedure. There is also a small risk of infection at the surgical site. The most important thing is that tissue is handled gently and trauma is minimized, whichever approach is used. 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. The doctor is planning a traditional posterior. This can cause you persistent pain, stiffness . The posterior approach is used frequently again, in large part due to the fact that it is an extensile approach. Im now 6 weeks out and doing good. This robotic technique can assist in producing an excellent result. Others will be empowered when they read and relate to you and/or your experience. Not sure exactly what that means. 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. Woke up with I had a posterior, the surgeon did not cut any muscle, they just move them now. What is your experience and take on this ? I also regularly receive Rolfing treatments which has helped me manage pain and maintain what mobility I have. Fortunately, if the components are stable (bone-in grown or cemented) and optimally positioned, and the surrounding tissues has fully healed and matured, then that risk is very small. That being said, I agree completely with your surgeons advice to have a total hip replacement and not a hip resurfacing. Can you compare/contrast to the other approaches; posterior, mini posterior, anterior? Have you ever performed the Mini on a patient 1 year after major open heart surgery? Irrespective of the approach that is used to implant the prosthesis, the tissues that surround the new prosthetic hip must heal and mature if the hip is to achieve stability. It is a pity that medicine cannot be as definitive as science but relies on historic figures and the future outcome appears to be a statistical probability! It's a hip replacement surgery where you lie on your side. 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. I walk a lot in my job and bend lots (work with children) and sitting causes pain due to impingement. Thank you very much for taking time to reply me. According to Dr. Rosen, the most important thing to remember is what you leave behind rather than how you get there. Every patient needs to have as limited an approach and dissection as possible that does not compromise the final implant position or create excessive trauma to the soft tissues. My question is: should I just tolerate the pain and limp, or take a chance with the hip replacement. Publications 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. I had to cut some strength exercises out leg lifts, hip sled. Other conditions, to which you alluded, such as having a back condition and an arthritic knee and foot, all can masquerade what the real or most debilitating problem is. Surgery carries increased risks because of these conditions, but by defining the risks and optimizing any underlying conditions, the risks can be minimized and hopefully managed. By far the most important variable is the doctor who is doing your surgery and managing your post-op care. Since these providers may collect personal data like your IP address we allow you to block them here. 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 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. Patients can also have as little as a 3-inch incision. Do either of your techniques require the traditional anterior or posterior precautions? This allows you to resume normal daily activities quickly while also returning to normal range of motion and function. When discussing the options, my surgeon all of a sudden suggested performing anterior approach. 10 users are following. I furniture surfed in the house and used a stick outside.I was hopeless with crutches, but I think it is recommended we should use them, particularly to ensure we don't get a limp and build our leg up properly. I am a 73 year old woman who has been having severe hip pain for the last seven months. The second most-common injury is to the femoral nerve. My surgeon does the SuperPath method. It is critical that the patient is aware of the risks, benefits, and alternatives of the procedure. The vascular supply of your leg must be assessed preoperatively as part of you work-up, but most do very well. I exhausted all other non-surgical options, such as physical therapy and meds but to no avail, so now plan to have a THR in March. Yes, you do have increase risks. Regarding restrictions after your hip replacement, this too is an area that has changed drastically over my 25 year career. I went with a total hip replacement. This interval must be developed and the muscles must be separated in order to reconstruct the hip. Also, the surgeon said that I would end up having one leg shorter than the other is this true? Fort Lauderdale, FL 33334 In my experience, after four to six months most patients simply return to normal activity. 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 . This is because the nerve is located in front of the hip. 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. I'm so encouraged to hear your successful story. 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? 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. Your article is the first Ive read in which no muscle or tendons are cut in any approach other than the direct anterior approach. What reasons would there be to use the regular over the mini? There are many factors that contribute to whether or not someone is a good candidate for anterior hip replacement surgery. Pain and disability are reduced. 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. Will I be able to dance, hike, bike, swim, exercise after a 3rd surgery? Fortunately, the incidence of hips dislocating after THR is very small, especially after first-time hip replacement. Over the last decade total hip replacements have been performed using 2 main approaches: The posterior approach in which the hip joint is approached from the back by releasing and reflecting the short external rotators and dividing the capsule at the back of the hip; and the anterolateral . I have/had arthritis in my hips. 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. 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. She provided all kinds of benefits with this approach, as faster recovery, less motion restrictions et.al. The most important decision you must make is choosing your surgeon. Thanks for giving us patients the kind of information we need to be more educated as to what questions to ask. I already have an artificial knee that is doing great. Many people seek anterior hip replacement due to the unbearable pain they feel in their hip joints. An anterior-approach hip replacement necessitates a small incision in the groin area on the front side of the leg. My hope is that some of these symptoms will improve with time. This then becomes a very difficult problem to solve. I choose to do them in a staged fashion because it is a significantly shorter procedure (more than half time-wise) and some think this lessens the risk of infection. I had an MRI by a different hip doctor (a preservationist) who diagnosed me with a birth defect (hip dysplasia). The rule of thumb is that recovery occurs over a 12-18 month period following injury. They may have a certain cut-off criteria (for example, a BMI of less than 35). Sometimes, it simply isnt possible to accomplish. Full Function, Faster . However disadvantages include the inability to adjust for leg length differences and a relatively high risk of femoral neck fracture. 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 a 67 year old woman who has danced semi-professionally and has always been very active including doing Ashtanga yoga and caopeira. 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. There are risks and recovery times associated with surgery. Not putting you on the spot, but would it be advantageous for me to drive 200 miles to have a consultation done by you? I definitely would not recommend a hip scope and THR during one anesthetic setting. Simply, we keep trying to get better. My husband, who is only 35, has to consider a THA in the near future and Im very torn over which approach as the surgeon we really like dos a posterior but I am concerned about dislocation rates in posterior vs anterior. Although Superpath hip replacement is often a safe treatment, it may be associated with certain concerns, such as increased postoperative pain, as with any surgical procedure. 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. Even though I was positive I wanted this method done, I was still questioning my decision. If you feel confident in your surgeon, I would discuss it frankly follow his or her guidance as to which approach and prosthesis are most appropriate to give you the best result. I encourage my patients to talk to other patients for whom Ive cared and learn about their experiences. An anterior hip replacement is not covered by a specific credential system for orthopedic surgeons. So my concerns include having the range of motion to perform moves like promenade where my body is roughly facing forward and my right leg will take a step left across my body at about 90 degrees. It's what compelled me to seek out different methods and post here.. You will find the surgeons will all give the pros but never the cons what ever the method. Im so pleased to learn that you had a good experience. Each approach you list has advantages and disadvantages. Ten years ago I had total hip replacement on the left at hss. I am still a very active 67 yr old, I like to ski, bike, hike (steep terrain) with about 25 pds. 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. We provide the best cash prices and customer care in the industry. Thanks again for this great blog! I am having the mini posterior done in June and my surgeon gave me the pros & cons of both. Procedures 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. This is particularly true if the person is overweight, has very muscular thighs or is short.

Lieutenant Governor Hawaii Apostille, Arthroscopic Knee Surgery Cost Without Insurance, Homestuck Class Personalities, Apartments Under $700 In Fort Pierce, Fl, Cavalier King Charles Spaniel Puppies For Sale In Missouri, Articles D