disadvantages of superpath hip replacement

I wish you luck on your journey. July 2013 my left hip was scoped for a labral repair. I needed no physical therapy at all. If possible, choose a hospital that specializes in joint replacement and can back that up with excellent statistics and reputation. Extensive release of the posterior capsule including . The approach planned is a frequent topic of Continued This is particularly true if the person is overweight, has very muscular thighs or is short. If they are really happy, then you probably will be as well. 2021 May 20;16(1):324 . Egton Medical Information Systems Limited. However, I now have quite severe OA in my right hip apparently I have no cartilage left and have been told by a surgeon that I am just lucky not to be in constant pain. I don't think there's a one size fits all when it comes to hip surgery. I think there may be increased associated complications. It is important to consider the SuperpathTM technique if you are considering a hip replacement. I was told the joint lubricant had migrated into the hip bone creating the cyst, There is effusion in the joint and stress areas. Hip Resurfacing vs Total Hip Replacement - sosbones.com Do I have a risk of fractures during a posterior right hip revision due to my prior complications already? Full Function, Faster . As a result, you are unable to pick up something from the floor or bend down to tie your shoes. Dr. William Leone. Clearly, yours was. I am a very active and young 69 year old female who had a THR on my left side 5 years ago. What are the risks involved? Even a task as simple as putting on socks and shoes can result in debilitating discomfort when a severely damaged or arthritic hip is involved. 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. Should I look to another approach and surgeon? 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. I had no inkling of this till he showed me on the x-ray. Does either procedure in this discussion present restrictions or advantages for this sort of movement? Pain Management 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. SuperPATH Total Hip Replacement Phoenix, AZ | Total Hip Replacement Arizona Thank you so much for taking the time to inform us! I was so against doing this surgery but groin pain was very bad and crushed bone in the groin. Help. I wish you the very best, I suspect there is significant underlying osteoarthritis related to your labral pathology. The most important thing is to get a top notch surgeon and go with whatever approach they offer. There is a possibility that blood loss may be reduced as there is less unnecessary exposed bone surface left to bleed. Hello Dr Leone, These scores are not aggregated. Risks of SUPERPATH hip replacement surgery Risks due to the surgery may include (but are not limited to): Pain Bleeding Infection Permanent or temporary nerve damage Extra bone or tissue damage Drop in blood pressure during the procedure Leg deformity Blood clot or clots (that could travel to heart or lungs) Delayed wound healing All of these releases may be necessary as part of the surgery and patients do well. 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. I understand they have good results in Thailand or India for half that. If this occurs, the patient usually requires a total hip replacement. The leg lifts really aggravate the front of the hip. Please be aware that this might heavily reduce the functionality and appearance of our site. He is well known as a top doc for 20 yrs & I was persuaded because the mini posterior has less chance of nerve damage & the surgeon has more options for types of spikes, which your article explains well. It exploits the inter-muscular interval between the tensor fascia lata and the gluteus medius. Check to enable permanent hiding of message bar and refuse all cookies if you do not opt in. I still have some questions I hope you can answer as this is so distressful for me. In my experience the approach used to replace a hip does not effect how quickly a patient recovers. Is THR something that can help? I was discharged within 24 hours. The size of the incision is determined by how large and tight the hip/thigh is and how much tissue (fat and muscle) exists between the bones of the hip and the overlying skin. Comments about life-long hip restrictions between Posterior, Anteriorlateral and Anterior approaches? Currently, I seldom do bilateral THRs under a single anesthesia but instead stage the surgeries 2 1/2 to 4 weeks apart, depending on my particular patient and his or her needs and desires. 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. I have since read that hips with this condition might get worse after labrum repair due to this structural defect. The anterior approach, as opposed to the lateral or posterior approach, uses a small incision in the front of the hip. I would not anticipate them improving with time, but rather worsening, and I cant imagine you being able to resume the activities you described without having surgery to treat this. I have congenital hip dysplasia which has gradually caused more pain as Ive gotten older. We have an appointment today to discuss the plan of action. I was initially sent to a surgeon to consider repair but he said my chances of being happy with the outcome were only 30% and suggest a THR. Yes, Im angry. I, too, am struggling which approach to have. There is also a risk of the hip joint not fusing correctly, which can lead to pain and instability. Regarding restrictions after your hip replacement, this too is an area that has changed drastically over my 25 year career. Orthop Clin North Am. Can I expect any problems with the bilateral it was my choice. SuperPath Hip Replacement Baton Rouge | SuperPath Surgeons Baton Rouge Apples to apples which procedure has the lowest incident of complications? Can I make an appointment with you. And, I Do. I suspect that your surgeon has continued to refine his or her technique based on experience over the past five years, in the same way I have. I dont think there is one best prosthetic. Some have features that are more suited to one persons anatomy and needs than others. I am a South African and need to make a decision on whether my mother (69) goes for an AMIS or traditional posterior. We are always refining and trying to make it better. I also regularly receive Rolfing treatments which has helped me manage pain and maintain what mobility I have. Its been 8 months now. The anterior approach is not as muscle sparing as some would argue. 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. Do you agree? Remember, what youre hoping to do is have a hip construct that will last 20 years or more. I worry that replacing it with a differently configured socket could make things worse rather than helping. I had to cut some strength exercises out leg lifts, hip sled. Thanks! Sex After a Hip Replacement: Positions, Tips, and More - Healthline Cant afford a dislocation or other complications cause Im sole caregiver for severely handicapped son. I have been doing ALOT of research about the different approaches to THR and looking for the absolute best surgeon. I am Australian so no business from me but it has helped me become happier with my prospective surgeons judgement that he will offer me a posterior THR (hopefully the minimally invasive) when my insurance allows the procedure to occur. The bone isn't dislocated in surgery. 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. It will help desensitize and help get your muscles working in synchrony. What is the best stem and ball/socket combo to use for someone that ones to play tennis? SuperPath hip replacement is a newer method and has been used since 2019 at Leicester's Hospitals. There arent any activities that you can do with a resurfaced hip that you cant do with a total hip. This technique is also referred to as the . I am about 5 6 and 185 lbs, age 58, he did not think the weight was an issues. The most important variable is how quickly the person is motivated to return to work. I think seeing several surgeons for different opinions is good judgment. There are a number of different potential surgical approaches available for hip replacement, each with their own potential advantages and potential drawbacks. I think it was sensible being careful on the other hand and I was told not to cross my legs. When the capsule is fully healed, it forms strong ligaments that will eventually regrow (it will take about 4 months for the capsule to form again). If you are minimally handicapped with discomfort from the non-operated hip and the leg length difference is tolerable or easily managed with a shoe lift or modification, I would consider waiting. Since then, SuperPATH has enjoyed excellent success. There are many benefits to posterior hip replacement surgery including a quicker return to daily activities, a more natural feeling hip joint, and a decreased risk of dislocation. The first is that it is a major surgery, so there is a risk of complications such as infection. Hip replacements might keep you out of action for a considerable period. This procedure differs from traditional hip replacements in the following ways: There is no surgical dislocation of the hip. Each surgeon approaches these issues individually. SuperPath hip replacement is a differentiated total hip technique being performed by a growing number of experienced surgeons. I suspect that your surgeon has continued to refine his or her technique based on experience over the past five years, in the same way I have. In general, if someone is dedicated to the job, the return is very quick. Currently we use standard ways, called either posterior or direct lateral approach. Tossed the cane at three weeks and went back to work. The healing and maturation of this tissue takes time. Mar 13, 2013. I think the recovery time is the same though. Registered number: 10004395 Registered office: Fulford Grange, Micklefield Lane, Rawdon, Leeds, LS19 6BA. I then would strongly suggest you trust that person to decide what approach and what prosthesis predictably will deliver the best results. Unfortunately, short of conservative and supportive measures, only time will tell. I have never operated on another surgeon who asked me to make as small an incision as possible or use the minimally invasive approach. 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. The surgery time is much less with a single joint and therefore the sterile surgical instruments are opened and exposed to the environment for a shorter time. Achieving legs that feel equal in length after surgery is imperative. (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. 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. It's cut off and removed through the hole. 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. For many years, I performed bilateral THR and bilateral TKR procedures, but have backed away for a variety of reasons. Most patients are able to walk the day of surgery. My walking is very limited, shoe is built up as leg is shorter and in recent months Ive realized my leg is bowed. I think researching the hospital where you will have your surgery is very important. Are my findings that posterior approach in my situation would have been more appropriate? Thanks! The development of a complete and secure surrounding scar tissue wall or pseudo capsule is critical for stability. What are the experiences of other countries with THR? 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 . My surgeon has told me I will need PT 3 times a week for 6-12 weeks is this too long? We are an online blog dedicated to providing comprehensive and accurate information about orthopedics and injury prevention. There always are conditions or circumstances that may predispose one to limp or feel as if their legs are not the same length after surgery, but in my experience this is the exception. Its been 9 months(Ive had it 2xs bf and got rid of it and have tried everything and no results this time). Patient does not provide medical advice, diagnosis or treatment. I believe going home is very therapeutic and often safer. J Bone Joint Surg Am. Disadvantages of the anterior approach include: The nerve which supplies sensation to the front and side of the thigh is vulnerable. You should not proceed unless you know in your heart that you will be taken care of in a manner that has the best chance of giving you as perfect a result as possible. I didnt spend time on boards talking for eons about peoples outcomes.probably a good thing I didnt. I think it is important to define and isolate why youre doing so poorly. It is also important to avoid any sudden movements or twisting motions. Individual results and activity levels after surgery vary and depend on many factors including age, weight and prior activity level. Gary. I have read your articles about procedures (anterior vs posterior). 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. Welcome to Brandon Orthopedics! I will need the other hip done within the next 6 months, and despite all the talk of the anterior approach- I can use myself as the best judge to the best method. If you have an abnormal anatomy or are morbidly obese, you may not be a good candidate. 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. 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. Intervals between muscles are separated or muscles are separated in line with their fibers without injuring the muscles innervation. Some people also tend to form scar tissue and contracture more readily than others. Traditional Hip Replacement - Traditional surgery requires a large incision of 10 to 12 inches and detachment of muscles from the hip. Anterior vs. Posterior, Posterior vs Mini-posterior. Since I previously had both knees replaced (by another surgeon) about 5 years ago and still have problems with the knees i.e. I have many patients who are accomplished and passionate ballroom dancers. It is important that the individual who ultimately implants your next THR uses the approach which he or she feels comfortable with and has the best chance to deliver the optimal result. I again suggest you concentrate on finding a surgeon in whom you have faith and then trust that doctor. The hip joint can be supported by the socket, which is designed to fit over the ball and provide stability. Notes on SuperPath experiences good or bad, https://patient.info/forums/discuss/superpath-experiences-good-or-bad-718788. superpath total hip replacement animation - YouTube Dr. Leone, I am coming in to see you for an appointment for a THR to my left hip. My doc said the angle of my hips is not the worst but also not the best. 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. Dr Leone, you make the point several times that the surgeon, not the procedure is most important. There are risks and recovery times associated with surgery. 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. Seeing that a THR is considered major surgery, my question is, should I have my left hip done sooner than later to address the length difference or wait until I can no longer tolerate the pain? I'm so encouraged to hear your successful story. Im not sure why you developed a problem with your IT band. 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. Im so against any other replacements as I have other issues, but working with alternative treatments, out of pocket money, as my hip replacement has been a horrible drama/saga. It is difficult to get that from information which I find curious. I can still do 30-45 mile rides, but I need to take something before each ride, because of the undone left hip. 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. As a result, patients can return to their normal activities much sooner than if they had had traditional hip replacement surgery. 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. Doc says once recovered I should avoid flexion with adduction and internal rotation. Will meet with doctor soon but when I was finally able to really exercise after surgery I overdid it and developed plantar fasciitis. One of the biggest changes that Ive seen in my practice over the past 25 years is how quickly patients get well and go home. It is possible that you will be required to avoid certain high-impact activities to protect your new hip. I dont want a long recovery time as I am very active. 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. In my practice, I cement an Exeter stem in a significant percentage of my patients who undergo THR . According to the meta-analysis, DAA (depressing the anterior hip joint by using a metal rod) is associated with significantly shorter hospitalizations than lateral approaches, as well as increased functional rehabilitation and lower perceived pain during the first few days after surgery. Glad that after lots of PT and massage and medial branch block for back issues with NO!!! Surgical Approach Types | Hip Replacement | Elvis Grandic, MD Im sorry to hear that you struggled after your first, anterior-approach THR. Is a prerequisite for THR to have a MRI or Pet Scan? hi im following as im due a superpath soon, there is no one size fits all everyones different I've had 2 hip replacements in 2 yrs one in 2017 then a revision to change the ball and socket to the smallest one they had and now I'm going for a smaller stem I had the anterior approch done which is in the front which is way better then the posterior as the front they can just move ur muscles over to the side to accsess ur hip rather then go through the back or side where they have to cut the muscles. In has been my experience in life that if others are happy and had a good experience then that speaks strongly to me, if I were to do the same thing. The mini posterior approach essentially is the same as the traditional posterior, however a smaller incision is made and less soft tissue is exposed. To have your other hip replaced through a different approach is a decision you need to make with your surgeon. A hospital outpatient surgery can cost between one-third and one-half the cost of an outpatient surgery atCOSC. In comparison to traditional methods, anterior approaches to the hip joint are more effective. Once it exceeds this ROM, impingement occurs. They are addictive, can cause depression, their analgesic effects are short lived and if the condition persists, you will require an increasingly higher dose to relieve the pain. Part of those possibilities includes a better and more comfortable sex life. Comparing Short-term Outcomes After Direct Anterior and SuperPATH Hip Start your day off right, with a Dayspring Coffee Which is the best? 1. Testimonials I also recommend that you look at the track record and reputation of the hospital where the surgery will be performed, especially considering the underlying cardiac and vascular issues. In the dark to find out about this myself. Its been a couple months and I thought Id drop in with an update..over 4 yrs post op and I deal with Femoral nerve damage from Anterior, and found others who deal with the same.it may lessen with more years but who knows.Somewhere I read 15% or so end up with this..I talked 2 other people in my city, same surgeon and they have had this issue to. Lazaru P, Marintschev I. Also, if this nerve injury occurred, I would expect these symptoms to be present immediately surgery, not five months post-op. Considering I had no idea about differences between the two approaches, I said OK and surgery did go well and I was back on my feet in no time. Reconstructing the opposite hip hopefully will result in legs that feel more equal. Optimal component positioning also is critically important for the best stability and longevity. I absolutely would not insist on minimally invasive surgery and a small incision, especially considering your mom is short, obese and has osteoporosis. What is most important is that the surgery is expertly done, that the tissues are not brutalized, and that the surgeon can see what he or she is doing. On the other hand, there may be a slightly increased incidence of anterior instability. Because the femur is more difficult to expose during the anterior approach vs. the posterior approach, many surgeons will select a shorter femoral component to facilitate reconstruction and lessen chance of fracture. Six months ago I had a right posterior THR due to severe scfe; now my right leg is 5/8 longer than my left leg. The most common reason or diagnosis that leads me to replace the hips of young women is hip dysplasia. Also if the mini posterior approach is so effective when would it not be preferred over the regular posterior approach? This too will lower your anxiety and improve your experience. Posterior approach. Procedures I would rather my patient get half as much anesthesia. Because the patient is lying on his back, it facilitates using a fluoroscope or moving x-ray throughout the procedure. Therapy hopefully will help any contractures and scaring within your muscles that might have developed after surgery. The anterior approach exploits an interval between muscles that cross the front of your hip and thigh. Can you compare/contrast to the other approaches; posterior, mini posterior, anterior? There is a chance of nerve injury with any type of hip replacement. Many others feel the same. I know the most important decision you will make is choosing the doctor who will perform your surgery. . There is a 1-2% risk of fracture of the femoral neck. I still have a very big limp and still undergoing physical therapy. Read our editorial policy. I definitely would not recommend a hip scope and THR during one anesthetic setting. Your article is the first Ive read in which no muscle or tendons are cut in any approach other than the direct anterior approach. If your little voice is questioning if you are overdoing it or hurting yourself, then listen to it and ease up. 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. As a result of anterior hip surgery, there is little need for any special care. Dear Dr. Leone, 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 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. A hip replacement involves removing the ball (femoral head) and replacing it with a metal or ceramic prosthetic ball. Thank you for this information. Many patients approach this by researching online and speaking to other patients who have been cared for at a particular facility. The questions youre asking are 100 percent appropriate. Everyone I know that has had both posterior and anterior surgery say not to even consider posterior. Can You Go Home the Same Day After Hip Replacement? Many studies suggest that any limp or clinical weakness resolves after approximately three months. A major hip replacement can take up to four months to fully recover from. Click to enable/disable _gid - Google Analytics Cookie. Also on MRI there was a cyst (good size). I have seen 2 doctors one doing posterior, the other anterior. This is described as a posterior approach because the actual hip . It is critical at time of surgery that an excellent range of motion be created without impingement. Once you find that doctor, then you need to put your trust in him or her to help you solve this horrible problem so you can return to being active and productive. What do you consider to be the most important factors in choosing a surgeon? Your article has made it clear I made the correct decision, especially since my daughter had nerve damage from an operation years ago. This robotic technique can assist in producing an excellent result. Regardless, the overall incidence of dislocation for every approach is smaller due to use of larger femoral heads and enhanced closure techniques. I think it perfectly ok to discuss different approaches and ask for an opinion. 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 understand that most surgeons now do a spinal rather than general anesthesia. I just want to thank you for the information on this site. Dr. William Leone. Low-risk anterior approach patients are those who have significant deformities in their proximal femur as a result of previous trauma or dysplasia, or who have previously suffered from acetabular bone fractures. 2015 Aug. 3 (13):179. Also, is it immoral for an 80 year old to have THR and cost the nations health care system $25 $35k? emergent norm theory quizlet. Posted I had a consult with a surgeon who does posterior and cuts muscle & tendons. Initially I was hesitant of THR thinking I was way too young for something so drastic but Ive now been miserable enough long enough that I am welcoming the idea of surgery. (Of course, I do.) I was thinking of doing that 1st, maybe April(Ill be in boot 4 weeks), and then the PTHR in either Sept or next Jan when I have free time. During the procedure, the patient must have a small incision made in the side of his hip. Mine certainly have. When a patient feels better, they can return to work almost immediately, though it usually takes two weeks or longer. Nerve regeneration can occur up to 18 months following injury, but the chance of full recovery decreases with delay in recovery time. Because these cookies are strictly necessary to deliver the website, refusing them will have impact how our site functions. From what Ive seen, most THR patients dont need very much PT, although I do encourage exercising in a pool. No specifics were given to me from the orthopedist .

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