We thank you for your readership. There is no definitive answer to this question as different people will have different opinions and preferences. Im hoping to play tennis, go dancing and horseback riding once Ive healed. An artificial joint is used to replace the worn out hip joint during a hip replacement procedure known as posterior hip replacement. No i just had the posterior method which has a larger incision. An anterior-approach hip replacement necessitates a small incision in the groin area on the front side of the leg. 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. Depending on the stability and range of motion observed at time of surgery, some doctors dont advise their patients to avoid any positions. If your little voice is questioning if you are overdoing it or hurting yourself, then listen to it and ease up. Sometimes the pain goes away as I walk and sometimes it doesnt. 2. I would stay away from narcotics. The femoral prosthesis is inserted into the hollow part of the femoral shaft. They thought it would give me about 5 yrs. A major hip replacement can take up to four months to fully recover from. Because the dissection is over the front of the hip, a number of patients will experience residual pain and tightness anteriorly (in the front of the hip) at least early on. Complications I dont know what happens on that tablewas he in a hurry on Friday afternoon. There is also a risk of the hip joint not fusing correctly, which can lead to pain and instability. My surgeon wants to use the posterior approach and indicates that I eventually should be able to play golf again. 3 years ago, It is a pity that medicine cannot be as definitive as science but relies on historic figures and the future outcome appears to be a statistical probability! Our insurance covers both. 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. 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. Can you suggest any pain medication that would not interfere with anti rejection drugs? We can do this because of improved plastics. Being out of bed and moving soon after surgery adds to a patients safety and speeds the recovery. What is the best hip replacement option: anterior or Posterior? I am about 5 6 and 185 lbs, age 58, he did not think the weight was an issues. My husband tells me that I cry out in pai as I turn over during the night. Also, when a single joint is replaced versus bilateral, there is significantly less bleeding and hence a much decreased need for transfusion. Still going to rehab to reduce stiffness and increase strength but I am in better shape now than before surgery. 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. No, I would not tolerate the pain and immobility, if there is a reasonable way to relieve it. Others continue to follow traditional guidelines. It typically requires a 4 to 5 day hospital stay, 3 to 6 month recovery period . Infection. Today, everything from tools to techniques has improved. and Privacy Policy and steps will be taken to remove posts identified Optimal component positioning also is critically important for the best stability and longevity. Posted A hospital outpatient surgery can cost between one-third and one-half the cost of an outpatient surgery atCOSC. J Orthop Surg Res. 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. I, personally, have not had a patient dislocate following a primary total hip replacement in many years. appropriate medical assistance immediately. Thanks so much for your help, very grateful. By far the most important variable is the doctor who is doing your surgery and managing your post-op care. I think tennis, dancing and horseback riding are fine. No specifics were given to me from the orthopedist . Not sure exactly what that means. Complications from infection account for approximately 10% of all cases. The posterior approach is used frequently again, in large part due to the fact that it is an extensile approach. Share your concerns with your surgeon. They may have a certain cut-off criteria (for example, a BMI of less than 35). 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. Tossed the cane at three weeks and went back to work. Every prosthetic joint has a mechanical range of motion. 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. The surgeon does about 200 a year and people say he has a good reputation. 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. An anterior hip replacement procedure, on the other hand, performs the same function as an anterior hip replacement in terms of tissue shaving. Its also reasonable to ask to speak to other patients who have undergone THR using this technique to learn about their experiences and results. Thank you for all you do and for providing me with the information when I needed it. My two questions are: 1. Would you recommend treating plantar 1st? Did you have the surgery via Superpath method? Consult your doctor to determine if joint replacement surgery is right for you. I think the recovery time is the same though. I think speaking to a patient with whom you can relate and who has been treated by the physician youre considering also is invaluable. It's a hip replacement surgery where you lie on your side. If you would like a personal consultation, please contact our office at 954-489-4584 or by email at LeoneCenter@Holy-cross.com. As a result, patients can return to their normal activities much sooner than if they had had traditional hip replacement surgery. THR if a MRI or Pet Scan isnt done? Dr. William Leone, Hello Dr. Between your legs, you should sleep with a pillow for the next six weeks. A hip replacement involves removing the ball (femoral head) and replacing it with a metal or ceramic prosthetic ball. Gililand, our physician, explained the concept of health. This then becomes a very difficult problem to solve. My gait is off partially due to my hip but also I believe because of my body structure. The hip joint can be supported by the socket, which is designed to fit over the ball and provide stability. 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. Finally, because my patients are walking the day of surgery, most want to go home rather than to rehab. I think there may be increased associated complications. Does anyone ever attempt to do both at the same time if THR is determined? Patients are typi. I'm hoping to read some posts post surgery. Glad that after lots of PT and massage and medial branch block for back issues with NO!!! 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. Once it exceeds this ROM, impingement occurs. If your surgeon did a great job, that is something to respect. 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. Occasionally this even requires making a second, separate incision. By 2016 and over 300 SuperPATH cases, the results of very first 100 SuperPATH surgeries (the so called 'learning Curve') were published in a peer reviewed journal with . If I think you may be a candidate, I will refer you to a doctor in our area that does. Sometimes, when a surgeon is working too hard to reconstruct through a very small incision, the ends of the incision tear and the tissues are traumatized. Also, how about hip restructuring instead of Total Hip Replacement. Intervals between muscles are separated or muscles are separated in line with their fibers without injuring the muscles innervation. I went with a total hip replacement. Some other methods are effective, but they are less effective for patients who leave the hospital earlier. All have advantages and disadvantages. Also, patients with shorter femur necks and genu varus (lower angle between the shaft of the femur and the femoral neck) are more difficult anteriorly. These are some of the most grateful patients in my practice. 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. With mild dysplasia, positioning and implanting the new cup usually is not more difficult than with other conditions. A orthopedic surgeon may insert a numbing agent directly into a new joint, which can last up to 48 hours. When a patient feels better, they can return to work almost immediately, though it usually takes two weeks or longer. With much respect I look forward to your reply. Get Directions, Phone: 954-489-4575 Dear Dr. Leone: Patients who are significantly overweight (I specifically assess the amount of tissue between the skin overlying the lateral hip and the greater trochanter), who have significant long-standing contractures and restricted ROM, congenital dislocation, and marked acetabular protrusion (when the femoral head wears centrally into the acetabulum) typically require a larger incision and more soft tissue releases. 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. The art of surgery should mimic a well rehearsed ballet or symphony. Do either of your techniques require the traditional anterior or posterior precautions? Many believe that this results in less risk of infection. Pain and disability are reduced. Unfortunately, injury to the lateral femoral cutaneous nerve is a common complication after the anterior approach for hip replacement. The bone isn't dislocated in surgery. An anterior hip replacement is, in many ways, less risky than any other type of hip replacement. Above the ankle to the thigh.Had to use leg brace to Most of my patients now go home the day after their surgery or the next. I have read your articles about procedures (anterior vs posterior). Dr. Leone, I am coming in to see you for an appointment for a THR to my left hip. Do you have any advice or ballroom dancer THR stories to share? Fortunately, the incidence of hips dislocating after THR is very small, especially after first-time hip replacement. The intended interval between the front thigh muscles can be difficult to recognize and there has been an associated increase in injury to the femoral nerve or vessels. 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. Dear Dr. Leone, You can also change some of your preferences. Kenneth, You saw me in your office yesterday (I am 48 years old) as I had complications following a THR of right hip anterior approach with revision 4 days later for a slipped acetabular and then last week I had a dislocated hip.

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