disadvantages of superpath hip replacement

Can you suggest any pain medication that would not interfere with anti rejection drugs? Very strange The only problem Ive had post hip replacement is some on/off again groin pain. What Ive been able to achieve is find two nerve supplements that have taken away the burn/tingle on my thigh. These cookies are strictly necessary to provide you with services available through our website and to use some of its features. Dr. William Leone. Because these cookies are strictly necessary to deliver the website, refusing them will have impact how our site functions. 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. A major hip replacement can take up to four months to fully recover from. I am a 55 year old with a labral tear and moderate arthritis. I think the recovery time is the same though. I am totally confused and dont know which procedure to choose. A hip replacement with an anterior component does not require major muscle cuts and thus patients are less likely to experience pain and require less medication. I have/had arthritis in my hips. Patient does not provide medical advice, diagnosis or treatment. The impingement can lead to a levering out of the ball from the socket. Both approaches have been shown to have potential in research. Most receive a simple spinal with sedation. Have you recovered by now? How do you ask your doctor the questions you want to ask? This is used when the cartilage in the hip is severely damaged by osteoarthritis or other conditions. Can I make an appointment with you. Can You Use An Inversion Table With A Hip Replacement Any info would be appreciated. http://holycrossleonecenter.com/blog/hip-resurfacing-or-total-hip-replacement-a-candid-discussion/, http://holycrossleonecenter.com/blog/metal-on-metal-hip-replacements/, I wish you the very best recovery. Unfortunately, short of conservative and supportive measures, only time will tell. July played my last match when I buckled. Is AL better than P for this? I'm so encouraged to hear your successful story. Thank you for this! Hip Preservation Surgery | Duke Health The socket of the pelvis is machined into a hemisphere and a metal hemisphere is inserted into the socket. It would be interesting to hear what you have to say Doug. 10 users are following. In my experience, most patients who undergo a total hip replacement dont limp after their surgery and most feel their legs are the same length. Dear Jo Anna, 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. The parts may be attached to the bones in one of two ways. The incision made for the operation can be as small as three inches. During anterior approaches, fracture repair is much more difficult and necessitates the use of a separate incision. 5 Things to Know About Anterior vs Posterior Hip Replacement For centers like Phoenix Spine and Joint that use a robot, there is . 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. I am now bracing myself for THR surgery within the next year and am wondering if there is any big advantage in trying to have this done by a surgeon who offers the customised implant, as above. With much respect I look forward to your reply. Posterior, mini posterior or anterior? 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. 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. Ann Transl Med. That means you have an excellent track record. SuperPath experiences good or bad | Hip Replacement - Patient Thank you very much for taking time to reply me. In the right hands, both approaches do great. I went in with high expectations of coming out so much better off and here I am 5 yrs out limping more than ever and a NUMB thigh and worse knee and weak ankle. I dont know if this stems from the knee surgery but I do not believe so because I was well for about a year and a half. It is much better to precisely release and cut rather than tear or fracture. I am just under 5 ft and weigh 185. As you can see, there are no restrictions. It seems that whatever their particular approach is that is what they sell. The questions youre asking are 100 percent appropriate. I also would encourage you to choose your surgeon first not the procedure, approach or prosthesis. 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). I would then let that person decide with what approach they think they can best accomplish the surgery and deliver the best result. Nerve regeneration can occur up to 18 months following injury, but the chance of full recovery decreases with delay in recovery time. I do not want the approach to dictate the optimal construct which I hope will last 20 years and more. I encourage you to do the same. The physical build of some patients increases the difficulty. Thanks. results, I decided to see and orthopedic doctor was advised to have THR. 1000 NE 56th Street, I think it perfectly ok to discuss different approaches and ask for an opinion. Even in my practice, which is starting its 27th year, we continue to refine the surgical procedure, pre- and post-operative instructions and rehab (this is huge), pre- and post-operative pain management, and even anesthesia. Historically short press fit stems have not done well. Your back does need to be evaluated as well. The SuperPATH technique is arguably the least invasive hip replacement technique. I also think infection must be investigated and ruled out. 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 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 . 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? There is significantly less bleeding with the mini-posterior approach, notably reducing the necessity of a blood transfusion after the surgery. My acyive 60 year old husband is scheduled to have Mini posterior total hip replacement in 6 weeks. You should keep in mind that the vast majority of hip replacement pain reduction surgery patients are satisfied with their final results. Finally, in July 2013, the first SuperPATH Hip replacement in Australia was performed in Nepean Private Hospital, Sydney. Most patients after a bilateral procedure would not go home but rather a rehab unit. In my 25 years of practice, the variable that seems to have changed the most is how quickly people recover from this surgery when done well. As a result of anterior hip surgery, there is little need for any special care. This improved quality of life will be beneficial. These are all realistic goals. An artificial joint is used to replace the worn out hip joint during a hip replacement procedure known as posterior hip replacement. With that said, I would have probably just done the posterior with you if we lived in the US based exclusively on the time you take to respond! Granted I do deal with lower back OA and right knee OA and now all worse and now foot/ankle mess, all on right hip side. Would you recommend treating plantar 1st? Results of the surgery numbness in the right thigh, inability to stand on the right leg, muscle atrophy all confirmed by EMG and second orthopedic surgeon. I believe choosing your physician is the most important decision you can make. Im so pleased to learn that you had a good experience. Also, I am diabetic and have had two organ transplants and am extremely worried about infections, etc. Even though I was positive I wanted this method done, I was still questioning my decision. 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. I read hip dislocation is 28% higher after a revision, is it more then 28% after 2 revisions??? I would avoid the metal-on-metal articulation. This allows you to resume normal daily activities quickly while also returning to normal range of motion and function. I wish you a full and satisfactory recovery. An anterior-approach hip replacement necessitates a small incision in the groin area on the front side of the leg. In addition, patients prefer the anterior approach due to the absence of pressure on the Femoral nerve in the anterior approach. Walker to get around. If I can put you on the spot. Yes, Im angry. He treats a variety of hip, knee, and shoulder conditions, and performs hip and knee total joint replacements. I find that patients who are well informed and know what to expect prior to surgery get well even faster. Less tissue damage during surgery allows for a much faster recovery and no restrictions in range of motion when compared to traditional hip surgery. If so, how long until I can get back to normal living? The vascular supply of your leg must be assessed preoperatively as part of you work-up, but most do very well. My question is, I am a very active 67 yr old. 35 (2):153-62. Use of the forums is subject to our Terms of Use Because of the marked improvement in modern plastics, there is greater longevity and durability of acetabular plastic liners and larger femoral heads are used routinely which results in an improved the head/neck ratio and therefore the jumping distance for a hip to dislocate. Gary. 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. My gait is off partially due to my hip but also I believe because of my body structure. Talked to my foot doc and we decided on the Topaz procedure which has good results. Or are x-rays definitive for determining the exact reason for THR? I would also like to know about the customized implant, as I havent yet heard much about it. The Disadvantages Of Anterior Hip Replacement Traditional Hip Replacement - Traditional surgery requires a large incision of 10 to 12 inches and detachment of muscles from the hip. Sex After a Hip Replacement: Positions, Tips, and More - Healthline It requires surgical insight and skill to accomplish. 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 . The pain I get is in the groin and a sharp pain in the buttocks, that feels like muscle pain. Dr. Leone, I am coming in to see you for an appointment for a THR to my left hip. The Pros and Cons of Two Approaches to Hip Replacement: Mini-Posterior https://holycrossleonecenter.com/wp-content/uploads/2018/12/Screen-Shot-2018-12-10-at-3.48.24-PM.png, https://holycrossleonecenter.com///wp-content/uploads/2017/11/Leone-Center-Logo@2x.png, The Pros and Cons of Two Approaches to Hip Replacement: Mini-Posterior and Direct Anterior, Copyright 2018 - 2023 The Leone Center for Orthopedic Care. Thanks! After awhile the screws started shifting and poking up under the skin and they removed them. Everyone I know that has had both posterior and anterior surgery say not to even consider posterior. In my experience, there is a faster and more-consistent recovery with the mini-posterior. I just want to thank you for the information on this site. 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. Many patients approach this by researching online and speaking to other patients who have been cared for at a particular facility. What you can do is keep as good an attitude as possible and keep rehabilitating your leg. In the case of a worn or damaged ball and socket, artificial parts can be used to restore joint function. It normally takes about 3-6 weeks to resume normal household activities and about 12 weeks to resume recreational activities like bicycling or golfing. I think cutting muscle was in the past. After reading your articles, I have decided not to have anterior. Some patients report that symptoms increase in the not-yet reconstructed hip because of the leg length inequality. Le has extensive experience in primary joint replacements, complex revision surgery, periprosthetic fractures, and infection management. We have an appointment today to discuss the plan of action. Also if the mini posterior approach is so effective when would it not be preferred over the regular posterior approach? I would stay away from narcotics. As a result, patients can return to their normal activities much sooner than if they had had traditional hip replacement surgery. As of 2020 only Dr. Leone is using the latest hip technique called the SPAIREtechnique where patients no longer have hip precautions after surgery. This risk is greatest in older females with bone of sub-optimal quality. Six weeks or longer is the exception. I am a very active and young 69 year old female who had a THR on my left side 5 years ago. Depending on the degree of injury, you may need a knee brace to lock you knee in extension when walking until the quad function returns. Our clinical information meets the standards set by the NHS in their Standard for Creating Health Content guidance. Does my prothesis not last as long since I am now doing a 3rd surgery? Hip replacement surgery can open up a world of possibilities for people who have lived with pain and restricted movement. Potential Disadvantages of Anterior Hip Replacement Anterior hip replacement does have a few limitations: There may be wound healing issues Research suggests that people who undergo anterior hip replacement may be more likely to have a problem with wound healing, particularly infection. Dr. Himmelwright Introduces SuperPath to OIP The last page is asking the participant to self score their health that day out of 100. Click to enable/disable _ga - Google Analytics Cookie. My personal preference has changed from doing both hips during a single anesthetic to staged procedures two to three weeks apart. The anterior approach is not as muscle sparing as some would argue. If you refuse cookies we will remove all set cookies in our domain. Comparison of short-term outcomes between direct anterior approach (DAA) and SuperPATH in total hip replacement: a systematic review and network meta-analysis of randomized controlled trials. I came home with crutches, abandoned them at the front door and have not used them since. In my last blog post, I discussed minimally invasive surgery with regard to hip replacement. It is possible that you will be required to avoid certain high-impact activities to protect your new hip. Its been a nightmare for me going into 4 yrs post op soon. Dr. Daniel Le | Houston Methodist My surgeon uses the posterior approach. Glad that after lots of PT and massage and medial branch block for back issues with NO!!! Thank you for all you do and for providing me with the information when I needed it. Your blog on anterior vs posterior approach was very informative. There tends to be a lesser incidence of posterior instability with the anterior approach. This is particularly true if the person is overweight, has very muscular thighs or is short. Once the surrounding tissues fully heal, they then act as a mechanical block to the ball to keep it from being able to jump out.. Hips that are out of joint have an anterior hip replacement. Further, the extent of dissection is more minimally invasive, which also improves stability. The bone isn't dislocated in surgery. This can cause you persistent pain, stiffness . I then stage the second surgery as early as 2 or 3 weeks post-operatively. The most important thing is to get a top notch surgeon and go with whatever approach they offer. There is also a risk of the hip joint not fusing correctly, which can lead to pain and instability. Getting those studies will not change the reality that you will need THRs. That I knew this recovery may take 1-2 Does this mean my body may reject the metal of the post or cup? I dont think there is one best prosthetic. Some have features that are more suited to one persons anatomy and needs than others. 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. I am an obese female and will be 62 in February. Yes, you can do very well. I definitely didnt have any tendons or muscle cut and was cycling on the road from day 12 and back running at week 4 . Lateral femoral cutaneous nerve injury is the most common injury incurred during an anterior approach. Many believe that this results in less risk of infection. Every . In the front of the hip, fewer muscles are present, so the surgeon works between them instead of cutting through them and then detaching them (and then repairing them after the surgery). After the direct anterior approach, there is generally no hip precautions required, and motion is not restricted. It exploits the same soft intervals but it typically accomplishes prosthetic implantation and soft tissue balancing through a smaller incision and, more importantly, with less underlying soft tissue dissection. That being said, I agree completely with your surgeons advice to have a total hip replacement and not a hip resurfacing. Not quite in the past. I would like your opinion. I would discuss fully your goals and concerns. Which approach did the doctor take? I have a tilted sacrum, sway back and a very large posterior. The same is true for a surgeon who employs the anterior or anterior technique. Robert H. Sigmund, MD | Signature Orthopedics I would emphasize choosing your surgeon and not the approach. Adults of any age can be considered for a hip replacement, although most are done on people between the ages of 60 and 80. My surgeon is doing posterior and my reason is I am self employed with limited Time off available and hope to be back to work at least walking and driving in 4 to 5 weeks is this possible? The highly crossed linked polyethylene liners are now the gold standard in this country. Hip Replacement Surgery Technique Pros & Cons | Portsmouth Possibly, its secondary to an altered gait pattern or hip mechanics. This is described as a posterior approach because the actual hip . Also there are concerns about disruption of blood supply to femoral head with this operation. He strongly recommends the anterior approach as the only way to go. A mini posterior approach is a modification of the classical posterior approach. SuperPath hip replacement is a newer method and has been used since 2019 at Leicester's Hospitals. 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. There is a more than 200% chance of knee infection, most likely because the knee has more surfaces that can become infected with an infection. There are 5 questions, mobility, self-care, usual activities, pain and anxiety. 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. Most doctors have and continue to implant hips through the posterior approach. Also, be aware that as the nerve recovers, the smallest C fibers within the nerve recover first, which can cause a burning discomfort. Finally, because my patients are walking the day of surgery, most want to go home rather than to rehab. Had horrible groin pain issues and opted for the antior, I knew of nothing else as I consulted with a surgeon who was trained in anterior. I'm hoping to read some posts post surgery. In general, I would encourage you to consider all of your prosthetic joints a remarkable modern day miracle that must be cared for and respected. Im getting close to needing my left hip done. 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. They may be: Cemented to the bone. 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.