disadvantages of superpath hip replacement

Many manufacturers are responding to the surgeons desire for shorter stems and many are now available on the market. 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. If possible, choose a hospital that specializes in joint replacement and can back that up with excellent statistics and reputation. 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. Its been six months since surgery, my operating doctor keeps feeding me with lets wait another month stuff. I believe a THR will benefit you tremendously. 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. Many, many interactions and decisions go into the final result as well as someones perception of his or her result and experience. Dr. Leone, I am coming in to see you for an appointment for a THR to my left hip. If you would like a personal consultation, please contact our office at 954-489-4584 or by email at LeoneCenter@Holy-cross.com. Report / Delete Reply kelly1010 nicole66881 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. 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. I would encourage you to discuss your expected recuperation time and specific restrictions with your surgeon. 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. I wish you only the best, Blog You can check these in your browser security settings. If, on the other hand, the leg length difference is creating hardship and possibly discomfort in other joints such as the lower back, knee or ankle, I would consider proceeding with contralateral THR sooner rather than later. I typically do hip replacement on the get anterior approach in 90% of my patients. Most patients after a bilateral procedure would not go home but rather a rehab unit. I needed no physical therapy at all. On July 17th, I had a left THR. Excess weight causes a hip joint that has already been stressed to become more painful and disability-causing. I deal with OA lower back mess so know I see most likely how all this has played into the surgery. The only problem Ive had post hip replacement is some on/off again groin pain. Yes, you can do very well. If so, how long until I can get back to normal living? invasive posterior vs not so good with AMIS) whilst on the other hand, with one of your replies you state that surgeon experience should be considered with AMIS success rates and in other replies stating that both alternatives are good. Every hip implant has benefits and risks. There are many factors that contribute to whether or not someone is a good candidate for anterior hip replacement surgery. surgeons certainly do not go out of their way to cut anything, they move stuff about, if tendons do get damaged, it's more likely from the anterior approach as they have less 'sight' of the procedure due to the smaller incision. 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. Each approach you list has advantages and disadvantages. Adults of any age can be considered for a hip replacement, although most are done on people between the ages of 60 and 80. Do either of your techniques require the traditional anterior or posterior precautions? Following surgery, the surgeon will devise a routine for the patient to engage in that is both comfortable and safe. Dear Jo Anna, We thank you for your readership. A number of patients who have undergone this procedure are able to walk unassisted the day after surgery . Regarding restrictions after your hip replacement, this too is an area that has changed drastically over my 25 year career. Ive done PT and plan to continue working on strengthening my core and flexibility of those large muscles. Behavior. About this injury to me. A hip replacement is an excellent option for people who suffer from significant pain and disability as a result of arthritis in the hip joint. Many modern-day femoral stems are considerably smaller or more bone sparing than well-functioning stems of the past. I thought the newer procedure on the special table was the best way to go. I think there may be increased associated complications. 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). Thank you. My surgeon does the SuperPath method. 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. This procedure differs from traditional hip replacements in the following ways: There is no surgical dislocation of the hip. An anterior approach to hip replacement allows the surgeon to perform more limited views of the hip joint during the surgery, making the procedure technically challenging for less experienced surgeons. Return to the work place is an individual decision. Dr. Parsons has extensive experience in the posterior, anterior and superior (SuperPATH) approach to total hip replacement having performed hundreds of each. Very strange In my experience, after four to six months most patients simply return to normal activity. Having physio I understand they have good results in Thailand or India for half that. 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. I have linked back to several blog posts below that will give you more in-depth information. Im pleased that you will be coming in for an appointment. The hope is that these new designs will, but time will tell. There are 5 questions, mobility, self-care, usual activities, pain and anxiety. Did you have the surgery via Superpath method? If you would like a personal consultation, please contact our office at 954-489-4575 or by email at LeoneCenter@Holy-cross.com. You can resume your active lifestyle as soon as possible thanks to a new prosthetic hip. A shorter hospital stay and faster recovery are typical of this because there is less damage to the muscles. SuperPath hip replacement is a newer method and has been used since 2019 at Leicester's Hospitals. It sounds like he did fabulous job. That being said, you should have the additional surgery where you feel you will have the best chance of doing well. Its also reasonable to ask to speak to other patients who have undergone THR using this technique to learn about their experiences and results. Patients can also have as little as a 3-inch incision. 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. Dear Dr. Leone, Its been my experience that femoral nerves tend to recover more readily than sciatic nerves. As a result of the interventions, the surgeon has a better view of the hip joint. Welcome to Brandon Orthopedics! It is critical that the patient is aware of the risks, benefits, and alternatives of the procedure. Most individuals who have had total hip replacement surgery fall into this category and simply resume their lives.. Similarly, an engaged medical team needs to be available to help with care after surgery. While it is a surgery that does help many, many people, clearly you are struggling. We use cookies to let us know when you visit our websites, how you interact with us, to enrich your user experience, and to customize your relationship with our website. I prefer spinal anesthesia when possible because fewer drugs are used and often the experience is gentler. Sometimes the pain goes away as I walk and sometimes it doesnt. It is much better to precisely release and cut rather than tear or fracture. Typically, most are eager to go home the very next day; many have already progressed to a cane, which they will not use very long. I'm hoping to read some posts post surgery. The risk of revision surgery after a posterior hip replacement is the most serious concern. You are to be commended for taking the time to answer our questions. I already have an artificial knee that is doing great. For risks she mentioned all the usual I knew about from the first surgery blood clots/loss, dislocation, etc. When the stem is placed in the femur, it still destroys the same amount of bone for implantation, regardless of which approach is used. The surgical technique for a SUPERPATH Hip Replacement was developed as an advancement to traditional total hip replacement. 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. I understand and respect that many surgeons prefer doing them simultaneously. My mom is obese, short and has osteoporosis. So my question is in relation to my body structure. Also, in the U.S., nearly all stems which are being implanted through the anterior approach are press-fit rather than cemented. An anterior approach hip replacement is one of the most minimally invasive surgical options for replacing a hip. Complications from infection account for approximately 10% of all cases. Thank you, Rita. Had a total hip replacement aug 2013. 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. Thanks so much for your help, very grateful. Also, how about hip restructuring instead of Total Hip Replacement. Being discharged to a rehab unit is now the exception. I am concerned that I may have a pinched nerve and that that is what is causing all this pai as the pain is severe only in certain positions but when I am tired I also have a throbbing pain in the sciatic region.talk about the golden yearsI thank you from the bottom of my heart for the kindness and caring that you do in answering all these questions. There has been an increase in the range of motion. These positions include crossing your legs, bending your hip more than 90 degrees, or lying on your stomach. I believe going home is very therapeutic and often safer. Iliotibial (IT band) damage, had 2 months of ART release work on this issue. Is AL better than P for this? The best of luck to you, 2. Pain modifying drugs as well and as a course of NSAIDs might also be appropriate. Conserves the two main muscles that make up the front of the hip and upper thigh aspirated via the direct anterior approach. What are the experiences of other countries with THR? His hip ball was put back in the socket and he has done beautifully since. By adhering to the surgeons instructions as well as their pre- and post-operative instructions, you can reduce your chances of complications. If your little voice is questioning if you are overdoing it or hurting yourself, then listen to it and ease up. Do I have a risk of fractures during a posterior right hip revision due to my prior complications already? Cons of Robotic Assisted Surgery As with any type of procedure, Mako is not without its drawbacks. Walker to get around. 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. A hospital outpatient surgery can cost between one-third and one-half the cost of an outpatient surgery atCOSC. Hard-on-hard bearings, such as ceramic-on-ceramic as well as metalon-metal articulations, also resulted in larger femoral heads being implanted. 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. It also is more difficult for patients with some patterns of arthritis such as protrusio, which causes the worn out ball to migrate inward rather than upward into the socket. I dont know what happens on that tablewas he in a hurry on Friday afternoon. My walking is very limited, shoe is built up as leg is shorter and in recent months Ive realized my leg is bowed. 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. Thank you, Not sure exactly what that means. I am 37 and have suffered from AVN since I was 14. A mini posterior approach is a modification of the classical posterior approach. With SuperPath, there is no surgical dislocation of the hip. This suggests that something changed after five months. If this occurs, the patient may experience pain and swelling. Both approaches have been shown to have potential in research. Years!! We now have less-invasive techniques, better surgical methods of closing soft the tissue and more experience. Our clinical information meets the standards set by the NHS in their Standard for Creating Health Content guidance. I weigh 185 and am 54 and realize its ideal to lose weight prior to surgery (working on it as always). The SuperPATH technique is arguably the least invasive hip replacement technique. 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. I am so sorry to learn that you have had such a bad experience after THR. Above the ankle to the thigh.Had to use leg brace to Hip replacement surgeries are becoming increasingly popular due to their numerous benefits, such as increased range of motion, reduced pain and disability, improved mobility during pregnancy, and improved quality of life. Rather, they say Bill, please just do what you have to do and do a great job. Most activities of daily living have an element of hip flexion (knee up to head), which is a safe position after the anterior total hip. If you have an abnormal anatomy or are morbidly obese, you may not be a good candidate. I am deciding that my quality of life is in the toilet and need to get the THR done. disadvantages of superpath hip replacement. 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. It is 100 percent normal and expected to be scared before surgery. Imagine your femoral head lacking full acetabular coverage, resulting in an overloading of the superior aspect of your socket, hence the cartilage and labrum becoming damaged and ultimately breaking down. Also on MRI there was a cyst (good size). In 2013 I had a THA done on the left hip. It is also possible to have an anterior hip replacement during pregnancy. 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! Dr. William Leone. 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. According to Dr. Rosen, the most important thing to remember is what you leave behind rather than how you get there. We may request cookies to be set on your device. But this blog was a nice nudge toward the posterior. The doctor has scheduled me for total hip replacement in two weeks and he uses the Posterior approach, he didnt say anything about the mini part. I am feeling like this is a business like everything is else. He is passionate about helping his patients achieve the best possible outcome and is committed to providing the highest quality of care. 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. It's cut off and removed through the hole. From what Ive seen, most THR patients dont need very much PT, although I do encourage exercising in a pool. The mini-posterior approach involves separating the muscle fibers of the large buttock muscle located at the side and the back of the hip. Or are x-rays definitive for determining the exact reason for THR? I, too, am struggling which approach to have. Surgical Techniques Adductors refer to a group of muscles that insert into the medial (inner) upper femur and often become contracted with an arthritic hip. Some patients who have recently had anterior hip replacement may suffer from complications such as wound healing. In the hands of a master, all can produce wonderful and predictable results. Are these expectations realistic? 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. Disadvantages of the anterior approach include: The nerve which supplies sensation to the front and side of the thigh is vulnerable. But I am now in chronic low grade pain thats getting worse and dont know what I should do. It is normal to want to recover quickly and return to a very active lifestyle without pain. When the anterior approach is used, the soft tissues in the hip stay intact, allowing for better hip alignment. 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. (Of course, I do.) The anterior hip can be easily and naturally recovered by walking, simple home exercises, and isometric exercises. Sometimes, it simply isnt possible to accomplish. Hi Frances, did you have surgery posterior Superpath? Every surgery should be done with as minimally invasive approach as possible taking into account these other critical factors. The femoral nerve functions to extend the knee and also is responsible for sensations over the anterior and medial aspects of the thigh, medial shin, and arch of the foot. That I knew this recovery may take 1-2 A orthopedic surgeon may insert a numbing agent directly into a new joint, which can last up to 48 hours. Ten years ago I had total hip replacement on the left at hss. The SUPERPATH hip replacement is a new technique using superior capsulotomy that allows for implantation of the total hip components under direct vision through a single incision. It typically requires a 4 to 5 day hospital stay, 3 to 6 month recovery period . 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. I think cutting muscle was in the past. I had no inkling of this till he showed me on the x-ray. The main limitation after surgery is a lack of comfort. During the procedure, the patient must have a small incision made in the side of his hip. Fort Lauderdale, FL 33334 DAA had a lower rate of hospitalization and functional rehabilitation as compared to the lateral approach, as well as a lower perceived level of pain. These are all realistic goals. Since 1995, there has been an extremely low dislocation rate and an infection rate of zero percent. Your out-of-pocket costs for your hipreplacement will be impacted by a number of . Pain is almost gone and I am beginning to get back to my life. Are expected to be out of bed (hips and knees patients) the afternoon of their surgery and at least taking a few steps if not walking. Lastly, where can I find a great surgeon that takes FL Workmans Comp? Because the gluteus medius and minimus lie over the anterior capsule and insert into the greater trochanter, it does require greater trochanter osteotomy or more commonly a partial elevation of these muscles from their insertion, which can lead to damage. After reading your blog Im thankful he suggested this approach. as being in breach of those terms. This interval must be developed and the muscles must be separated in order to reconstruct the hip. Many times, the depth of the destruction that is found during surgery is much more advanced than initially anticipated, particularly as we age. We are an online blog dedicated to providing comprehensive and accurate information about orthopedics and injury prevention. I have two questions one, how realistic would it be to try to have both hips done at the same time? There is a chance of nerve injury with any type of hip replacement. Inpatient footage of the patient compilation has been edited out to accommodate hospital rules. Until now. Ken. The questions youre asking are 100 percent appropriate. Many believe that this results in less risk of infection. A miniposterior approach uses the same intervals as the standard posterior approach but simply less tissue is released for the exposure. 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. Hey, thanks for the forum topic.Thanks Again. Should I be though? With the ease of movements during pregnancy, you will be able to move around more freely. Patients understand the risks that metal joints and sockets bring to their long-term health and are moving away from the material. If a patient has abnormal anatomy (such as dysplasia, posttraumatic arthritis, or morbid obesity), or if their body mass index is higher than 35, it may be impossible for them to be considered for direct anterior surgery. It is important to consider the SuperpathTM technique if you are considering a hip replacement. Very slow recovery. Doctors use metal, ceramic, or plastic replacement parts. 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. 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 exploits the inter-muscular interval between the tensor fascia lata and the gluteus medius. No specifics were given to me from the orthopedist . Thank you for sharing with others the nerve supplements that youre finding affective. No special surgical equipment is required when performing a mini posterior. 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. One thing I do not want is any muscles or tendons cut in the procedure. I wish you the very best, When it comes to hip replacement surgery, the surgeons skill, the patients weight and build, and the surgeons level of experience all have an impact. Woke up with Also available today are larger modular heads, made possible because our plastics are so much better than years prior. Avascular Necrosis AVN of the femoral head happens when part of the ball at the top of your thigh bone loses blood supply, causing that segment of bone to die. Im a 50 year old female whose been dealing with hip, leg and back pain for many years, recently diagnosed with OA, and finding that I need a right THR. 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. There is a possibility that blood loss may be reduced as there is less unnecessary exposed bone surface left to bleed. I also think infection must be investigated and ruled out. I also have undiagnosed neuropathy in both legs from the knees down. 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. 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. 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. The hope is that your nerve injury will recover with time. I also would encourage you to choose your surgeon first not the procedure, approach or prosthesis. I have never operated on another surgeon who asked me to make as small an incision as possible or use the minimally invasive approach. Doc, Ive worked out and been physically active forever running, biking, skating, etc. Surgical Approaches To Hip Joint Dr. Apoorv Jain D'Ortho, DNB Ortho . My advice is to have a frank discussion with your surgeon and share these concerns. The majority of teaching institutions in the United States continue to instruct as well as perform the traditional posterior as their primary approach. 2. These cookies collect information that is used either in aggregate form to help us understand how our website is being used or how effective our marketing campaigns are, or to help us customize our website and application for you in order to enhance your experience. These cookies are strictly necessary to provide you with services available through our website and to use some of its features. 10 users are following. Also, be aware that as the nerve recovers, the smallest C fibers within the nerve recover first, which can cause a burning discomfort. However disadvantages include the inability to adjust for leg length differences and a relatively high risk of femoral neck fracture. Fewer narcotic medications are administered, resulting in a better overall recovery. Its been 8 months now. Because the patient is lying on his back, it facilitates using a fluoroscope or moving x-ray throughout the procedure. Dr Leone, you make the point several times that the surgeon, not the procedure is most important. I wish you a full recovery. Tossed the cane at three weeks and went back to work. My question is: should I just tolerate the pain and limp, or take a chance with the hip replacement. I was not aware that any of the local surgeons who is doing anterior approach. It can lead to numbness in the thigh and, in rare cases, skin irritation due to the nerves presence. 1.2. Other combinations of materials have advantages and disadvantages (for instance, some researchers believe that ceramic-on-ceramic types may be more durable, but they have also been known to make squeaking and popping sounds.)

disadvantages of superpath hip replacement 2023