disadvantages of superpath hip replacement disadvantages of superpath hip replacement

Being cared for in a hospital that specializes in joint replacement and has an extensive specialty medical staff also is key. Fax: 954-489-4584 From what Ive seen, most THR patients dont need very much PT, although I do encourage exercising in a pool. Is THR something that can help? In my experience, people recover from femoral nerve injures more frequently and completely than from sciatic nerve injuries. Doctors use metal, ceramic, or plastic replacement parts. I was not aware that any of the local surgeons who is doing anterior approach. Can you compare/contrast to the other approaches; posterior, mini posterior, anterior? One thing I do not want is any muscles or tendons cut in the procedure. Most patients decide not to wait as long to have their contralateral hips or knees replaced after having undergone a successful surgery on the first side. 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. My personal preference has changed from doing both hips during a single anesthetic to staged procedures two to three weeks apart. Changes will take effect once you reload the page. Pain modifying drugs as well and as a course of NSAIDs might also be appropriate. They may be: Cemented to the bone. As of 2020 only Dr. Leone is using the latest hip technique called the. I share your concern that with profuse denervation potentials 10 weeks post injury, that the patient may have sustained a more severe injury than a neuropraxia. Thank you. If you decide to have your hip replaced in another country, I would consider carefully who would care for you if you develop a complication such as an infection, or a major medical problem like a pulmonary emboli or heart attack after surgery. Share your concerns with your surgeon. The posterior approach for hip replacement surgery is by far the most common surgical technique used in the United States and throughout the world. Patient is a UK registered trade mark. Patient Concerns About how much does this cost? Optimal component positioning also is critically important for the best stability and longevity. 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. After reading your article I see there are many reasons to go with the posterior approach but nothing about having to use a smaller prosthesis with the anterior approach. 1.2. My question is: should I just tolerate the pain and limp, or take a chance with the hip replacement. Until now. Since I previously had both knees replaced (by another surgeon) about 5 years ago and still have problems with the knees i.e. It is a mix of anterior & posterior. If I do a single hip or knee replacement, that patient is out of bed standing and, in most cases, walking the afternoon of surgery. I am a 55 year old with a labral tear and moderate arthritis. Less tissue damage during surgery allows for a much faster recovery and no restrictions in range of motion when compared to traditional hip surgery. I have the hospital but am deciding on the surgeon and which approach is best. Behavior. Good question. Even after the procedure is completed and the patient is on pain medications, pain and discomfort may occur in some cases. This is particularly true if the person is overweight, has very muscular thighs or is short. I am unsure whether the minimal invasive posterior is available in SA. from publication: Current and . 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. Because I have scfe also in my left hip, I will have to have it fixed too. Our second opinion doctor performs traditional and Birmingham hip replacement. Personally, it I were caring for you, I would have advised you exactly as the orthopedic surgeon who took care of you did. With degenerative osteoarthritis of the hip developing secondary to a severe slipped capital femoral epiphysis (scfe), recreating normal hip mechanics after THR may have necessitated lengthening the first hip. A hip replacement can be delayed until it is absolutely necessary if the replacement parts can fail over time. Overall, however, anterior hip replacement is a safe and effective procedure with a high success rate. Your symptoms still sound mechanical, positional and episodic. It was discovered that I had a torn Labrum. 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 would encourage you to discuss your expected recuperation time and specific restrictions with your surgeon. Hip replacement via SuperPATH approach had a longer operation time than hip replacement via conventional approaches. It is normal to want to recover quickly and return to a very active lifestyle without pain. Dear Dr. Leone, My knee and foot and ankle are messed up too since leg ended up at least 3/4 shorter.I wear a shoe lift, but probably needed it sooner than I realized the shorter issue, My knee is pretty stiff and pain when I walk too much, but I deal with it, it bends good, I sleep good, no pain when I do nothing, so Im working all to do NO knee surgery, This hip was ENOUGH to last a lifetime.. Im 76 and use a lot of supplements to save knee and OA in general..I am looking at other protocols for the knee too.not insurance covered, what else is new.if its good, its out of pocket. 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 . He also used the term anterolateral. I think stem cell injections will have little chance of doing any good if indeed your hip condition has already progressed to bone on bone. Dr. William Leone, Hello Dr. Can you explain this approach? Sometimes during surgery it is necessary to release particularly tight structures to expose the joint for reconstruction or to better balance surrounding soft tissues after reconstruction. Also, I am diabetic and have had two organ transplants and am extremely worried about infections, etc. There is a chance of nerve injury with any type of hip replacement. Or are x-rays definitive for determining the exact reason for THR? I saw a surgeon who does the posterior approach only and will see another on 4/14/15 who does both approaches. The incision made for the operation can be as small as three inches. Tina, which procedure did you have? 1000 NE 56th Street, Nobody wants a long recovery. I still maintain that by far the most important decision patients must make is choosing the surgeon who will do their surgery and take care of them, then trusting that individual to choose the approach, prosthesis and make a million other decisions that deliver as perfect a result as possible. I had the posterior approach, the surgeon did not cut any muscle plus I had no pain at all after the op. The surgeon will be building a construct that hopefully will last her life time and change her life profoundly. The pain is really inconsistent, one min I will be walking fine and the next it catches and is very painful, then it may go away or may not. Update what hes cutting is the adductor so my question is the same is this just a normal part of some THRs? Egton Medical Information Systems Limited. A hip replacement can greatly reduce the pain associated with arthritis of the hip, with almost all patients having complete or near-complete relief. We are an online blog dedicated to providing comprehensive and accurate information about orthopedics and injury prevention. Testimonials Pain is almost gone and I am beginning to get back to my life. Anterior hip replacement has the potential to cause complications and pose some risks. On July 17th, I had a left THR. There is also a small risk of death associated with any surgery. Most doctors have and continue to implant hips through the posterior approach. I often suggest to my patients that they speak to other patients for whom Ive cared and to whom they can relate to learn about their experiences. Length of hospital stay with SuperPath hip replacement approach. He is one of the few surgeons in the U.S. that performs total hip replacement via a superior capsular approach, the most soft tissue-sparing hip replacement available and is an industry educator in the . This does not necessarily mean they will have more pain or take longer to get well. I just want to thank you for the information on this site. I had no inkling of this till he showed me on the x-ray. Although, personally I would feel strongly about reconstructing the hip through the mini posterior approach (there tends to be considerably less bleeding with this approach), other very caring and competent surgeons might feel just as strongly about using a different approach. Ive come to the conclusion that perceived benefits do not outweigh the risks with the anterior approach, especially when I can achieve the same or more using the mini-posterior. Report / Delete Reply kelly1010 nicole66881 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. That said, in general people who are longer, more flexible and thin are more easily constructed anteriorly than individuals who are very stiff, contracted, thick, and have acetubular protrusion (a condition when the femoral head wears away the central cartilage and bone of the acetabulum). Surgical Techniques Im hearing no restrictions (once recovery is done) for Anterior, but always some for the other two. I do participate in competitions and showcase presentations. The last page is asking the participant to self score their health that day out of 100. Dr. William Leone. I read hip dislocation is 28% higher after a revision, is it more then 28% after 2 revisions??? Recently the doctor doing anterior decided because of thin bone, he should do direct lateral approach. We are always refining and trying to make it better. The hip joint can be supported by the socket, which is designed to fit over the ball and provide stability. There is also a small risk of infection at the surgical site. 2. Many people seek anterior hip replacement due to the unbearable pain they feel in their hip joints. 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. In severe cases, I will use my patients own femoral head, which is removed as a bone graft to help stabilize the new cup and garden new bone for the future. These can include damage to blood vessels or nerves, dislocation of the hip, and infection. The posterior approach, then, is less inherently stable but may or may not require precautions. This surgical procedure is performed with a patient lying on their side, and a surgical incision made along the outside of the hip. Thank you. Stay was 2.5 days. Inpatient footage of the patient compilation has been edited out to accommodate hospital rules. I am wondering if having mild hip dysplasia is a factor in which approach is used. Therapy hopefully will help any contractures and scaring within your muscles that might have developed after surgery. I'm hoping to read some posts post surgery. 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. 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.. I have seen a number of patients who were reconstructed with the anterior approach who developed painful anterior scarring after the procedure. 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. 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 This can be dangerous because a piece of a clot can break off and travel to the lung, heart or, rarely, the brain. Dr. William Leone. Many modern-day femoral stems are considerably smaller or more bone sparing than well-functioning stems of the past. But Im impressed with your blog and responses, so am writing to ask you about an apparently new procedure in which the surgeon uses a customised implant, utilising pre-operative 3D CT scanning. Risks of Hip Replacement Surgery The major risks include the following: Blood clot: We do reduce risk of this by using blood thinners (Enoxaparin, Aspirin or Coumadin), TED hose (compressive stockings) and compression boots on your feet to increase circulation. Our insurance covers both. I am looking at how many hips they have done and where they are doing them. There is less risk of neurological injury. Many others feel the same. A THR is in my future. Even though I was positive I wanted this method done, I was still questioning my decision. There are various ways of doing a hip replacement. I am sure you should not listen to what I did!! Uncemented. During the procedure, the patient must have a small incision made in the side of his hip. 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)? Welcome to Brandon Orthopedics! Your article has made it clear I made the correct decision, especially since my daughter had nerve damage from an operation years ago. We have to get ok from cardiologist and get ekg, chest xray, etc. I think the recovery time is the same though. I am temped to wait but it is getting worse. General comments will be answered in as timely a manner as possible, Hip & Knee Surgery Will I still be able to do the things I like to do? Currently, the incidence of dislocation after the posterior approach has been greatly reduced due to technique and other refinements. In addition, patients prefer the anterior approach due to the absence of pressure on the Femoral nerve in the anterior approach. My surgeon has told me I will need PT 3 times a week for 6-12 weeks is this too long? The doc I saw yesterday said 4 weeks. How do you ask your doctor the questions you want to ask? People undergoing traditional hip replacement surgery, for example, are advised not to bend at the hip more than 90 degrees for approximately six weeks after the procedure. To have your other hip replaced through a different approach is a decision you need to make with your surgeon. Very strange I think it perfectly ok to discuss different approaches and ask for an opinion. What Ive seen in my practice is that the more total hips I do, the less restrictions I place on my patients and the more active my patients are. We are always refining and trying to make it better. What surgical approach is typical for a complex total hip replacement? July 2013 my left hip was scoped for a labral repair. Its been 8 months now. 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. I have had problems with my hip for the last several yrs. Thanks. Historically short press fit stems have not done well. The approach planned is a frequent topic of Continued Adductors refer to a group of muscles that insert into the medial (inner) upper femur and often become contracted with an arthritic hip. Your back does need to be evaluated as well. I am scheduled to have total hip replacement surgery in 2 weeks. I needed no physical therapy at all. Walking is the best exercise. There are 5 questions, mobility, self-care, usual activities, pain and anxiety. I have read your articles about procedures (anterior vs posterior). In general, people who are older, heavier, or more active may not be good candidates for this type of surgery. My surgeon wants to use the posterior approach and indicates that I eventually should be able to play golf again. 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. 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. He is highly respected by the medical and chiropractic community, so i plan to have a appointment to discuss his plans for my surgery. If you do not have a hip replacement, you will live a sedentary lifestyle and become overweight. Introduction. I wish you the best of luck, I am 56 now and find that physical therapy and chiropractic care dont seem to be helping anymore. The second advantage of a small incision is that it makes it easier to clean and care for the hip. The femur is prepared with the head and neck intact reducing the chance of fracture. Does this mean my body may reject the metal of the post or cup? I have a tilted sacrum, sway back and a very large posterior. Dr. Parsons has extensive experience in the posterior, anterior and superior (SuperPATH) approach to total hip replacement having performed hundreds of each. I am terrified of nerve damage as I am very athletic and a previous professional ballet dancer. Since a significant amount labrum has been removed, I think another attempt at arthroscopy would prove very disappointing and I would not recommend it. Superpath total hip replacement animation. Help. As a result of anterior hip surgery, there is little need for any special care. I, too, am struggling which approach to have. 2 x week. It is critical to make the right decision regarding anterior hip replacement surgery in each case. The surgery is more difficult and more exacting . The vast majority of my patients return to work one to three weeks post-operatively. 3. I worry that replacing it with a differently configured socket could make things worse rather than helping. Original Medicare (Part A and Part B) will typically cover hip replacement surgery if it's medically necessary. Can You Use An Inversion Table With A Hip Replacement Also many folks develop peripheral neuropathy in their lower legs, which also becomes more common with age. Does it really not matter which approach I have, posterior or anterior? I am having the mini posterior done in June and my surgeon gave me the pros & cons of both. 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. This risk is greatest in older females with bone of sub-optimal quality. Dear Dr. Leone, You can also change some of your preferences. disadvantages of superpath hip replacement. I was so against doing this surgery but groin pain was very bad and crushed bone in the groin. In 2013 I had a THA done on the left hip. If I think you may be a candidate, I will refer you to a doctor in our area that does. Do you have any thoughts on this issue? 2004 Apr. Patients can also have as little as a 3-inch incision. July played my last match when I buckled. As of 2020 only Dr. Leone is using the latest hip technique called the SPAIREtechnique where patients no longer have hip precautions after surgery. Not only was my recovery twice as fast with the anterior, there was very little pain in comparison. That being said, if the foot is now a much bigger problem than the hip, you may have to deal with that first. Im 51, 59 and 148 and want to get back to tennis etc, this has been long frustrating process. Also I have read that there is a sharp learning curve that must take place in order to do the direct anterior approach. Dear Dr. Leone: Dear Jo Anna, Lateral femoral cutaneous nerve injury is the most common injury incurred during an anterior approach. I weigh 185 and am 54 and realize its ideal to lose weight prior to surgery (working on it as always). Some patients who have recently had anterior hip replacement may suffer from complications such as wound healing. What is your experience and take on this ? and Privacy Policy and steps will be taken to remove posts identified Because of the restricted view provided by the anterior incision, the anterior incision is a technically demanding procedure. Thank you so much for your answer, I appreciate your taking the time to care about others. 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. 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. I would rather my patient get half as much anesthesia. I wrote to you in January, now my surgery is in a couple of weeks. The parts may be attached to the bones in one of two ways. After reading your article on disadvantages of anterior approach and also doing extensive online search about this subject, I came to realize that anterior approach was definitely a wrong choice considering my physical build short, muscular, overweight. An anterior hip replacement is not covered by a specific credential system for orthopedic surgeons. Infection. Finally, hip replacement surgery is expensive and may not be covered by insurance. Ceramic-on-polyethylene is currently the most popular hip replacement material, representing 50.6% of all hip replacement cases back in 2014. 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. Should one of these events occur during a mini-posterior procedure, they are easier to recognize and correct. I would like your opinion. Also, if this nerve injury occurred, I would expect these symptoms to be present immediately surgery, not five months post-op. Regardless, the overall incidence of dislocation for every approach is smaller due to use of larger femoral heads and enhanced closure techniques. 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. What determines the differences? There are a few complications that can occur with anterior hip replacement surgery. Its reasonable to inquire about his or her experience using the Mako robot. 4. There are a number of different potential surgical approaches available for hip replacement, each with their own potential advantages and potential drawbacks. Above the ankle to the thigh.Had to use leg brace to There are several positions to avoid after anterior hip replacement, as they can put unnecessary stress on the new hip joint and lead to dislocation. daniel neeleman net worth . No feeling in my leg and no movement It is important that these medical and cardiac conditions be optimized by your PCP and cardiologist preoperatively. Do either of your techniques require the traditional anterior or posterior precautions? 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. The SUPERPATH technique is a tissue-sparing procedure. Registered number: 10004395 Registered office: Fulford Grange, Micklefield Lane, Rawdon, Leeds, LS19 6BA. Having a THR is a major undertaking and it is reasonable to expect the hip construct to function optimally for twenty and more years. I encourage my patients to talk to other patients for whom Ive cared and learn about their experiences. I find that patients who are well informed and know what to expect prior to surgery get well even faster. With a bilateral procedure during a single anesthetic, the blood loss would be double and there would be a much higher likelihood that my patient would need transfusion post-operatively. I have written to you to learn what are the surgical considerations for someone with shallow hip sockets like mine. I am a 73 year old woman who has been having severe hip pain for the last seven months. We provide the best cash prices and customer care in the industry. With mild dysplasia, positioning and implanting the new cup usually is not more difficult than with other conditions. One advantage the ceramic-on-polyethylene carries is the lack of . Diagnosed possible labral tear. Historically in my practice I performed many Bilateral THR and TKR and have backed away from that practice. Thank you. First, I am a little bit scared. He strongly recommends the anterior approach as the only way to go. More likely, its because ones activity increases after the first THR. I would like to share my experience with both procedures. One of the potential disadvantages is that because the surgery is performed through the front of the hip, there is a risk of damaging the hip joint and the surrounding muscles and tendons. During anterior approaches, fracture repair is much more difficult and necessitates the use of a separate incision. The mini-posterior approach involves separating the muscle fibers of the large buttock muscle located at the side and the back of the hip. 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.