disadvantages of superpath hip replacement

Most of my patients now go home the day after their surgery or the next. I was thinking of a Hip Resurfacing for my left hip and was convinced by my other top hip surgeons to stay away from it. Some hospitals and surgery centers are promoting one method of hip replacement over another. thank you for your time. Apples to apples which procedure has the lowest incident of complications? I seem to be able to hike just fine up hill and down but not always on the flat. Really Great. Dr. William Leone. 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. When we quote probability of longevity after hip replacement based on following people who had the operation, it is based on standard length stems. I am unsure whether the minimal invasive posterior is available in SA. The socket of the pelvis is machined into a hemisphere and a metal hemisphere is inserted into the socket. Can you explain it to me as he didnt go into detail. Dr. William Leone. 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. Thank you. I wish you only the best, Click on the different category headings to find out more. Many, many interactions and decisions go into the final result as well as someones perception of his or her result and experience. Hip implants are medical devices intended to restore mobility and relieve pain usually associated with arthritis and other hip diseases or injuries. Infection. What is most important is that you find a surgeon who understands the particular complexities with your problem and whom you trust. I just had mine 10/30 all I can say is be patient get lots of rest and take your pain meds way before you start to move around so that the pain want be so bad with movement. Hip Resurfacing vs Hip Replacement: Know The Difference If theyre really happy and got well quickly, you probably will too. A ceramic-on-ceramic bearing is also a very good bearing. In my experience the approach used to replace a hip does not effect how quickly a patient recovers. Over the last six years, I have performed more than 2000 primary or first-time total hip replacements using the mini-posterior approach and I am aware of only one patient who dislocated his hip because he fell down stairs. Raleighs orthopaedic clinic is board certified and has fellowship training in total joint replacement. This allows you to resume normal daily activities quickly while also returning to normal range of motion and function. A less stringent set of precautions is required with the anterior approach. Thru X-rays Ive been told both hips are bone on bone! Dr. Sigmund holds a subspecialty certificate in Orthopedic Sports Medicine. A orthopedic surgeon may insert a numbing agent directly into a new joint, which can last up to 48 hours. I was released to go back to work after only 10 days. Original Medicare (Part A and Part B) will typically cover hip replacement surgery if it's medically necessary. I think it is important to define and isolate why youre doing so poorly. Total Hip Replacement Surgery | Kaiser Permanente Pros and Cons of Hip Replacement Surgery | IBJI My main concern is that I have a tilted sacrum and a very sway back. Also available today are larger modular heads, made possible because our plastics are so much better than years prior. 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 understand they have good results in Thailand or India for half that. Is Less-Invasive Hip Replacement Best for You? - WebMD No special surgical equipment is required when performing a mini posterior. 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? 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. I assume PTHR is referring to partial hip replacement. The chances of developing a revision surgery after a posterior hip replacement are low, but you should keep all follow-up appointments with your surgeon and inquire when you can resume activities that go beyond 90 degrees or bend down to pick up something small after your procedure. I am a South African and need to make a decision on whether my mother (69) goes for an AMIS or traditional posterior. We thank you for your readership. The SuperPATH technique is arguably the least invasive hip replacement technique. 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. Years ago, experts assumed that anterior hip replacement had lower rates of hip dislocations and nerve damage than other forms of hip replacement. An artificial joint is used to replace the worn out hip joint during a hip replacement procedure known as posterior hip replacement. What Ive been able to achieve is find two nerve supplements that have taken away the burn/tingle on my thigh. Also, if a surgeon knows in advance that a certain range of motion is desired, can they provide some adjustment in surgery to help accommodate that desired movement? Possible Infections Dr. Sutphen: A minimal number of surgery patients (roughly around 1%) can develop an infection around their hip replacement. The posterior approach, then, is less inherently stable but may or may not require precautions. Hi Frances, did you have surgery posterior Superpath? Choose your surgeon. My surgeon mentioned also cutting something to free me up at the same time he will be doing the posterior approach surgery. I have written to you to learn what are the surgical considerations for someone with shallow hip sockets like mine. Back to work/driving in 10 days. This left hip remained tender based on my exercise level which I did modify but always my hip had some soreness. You can be successful by staying healthy by sticking to less pain. I am scheduled for total hip replacement in about 3 weeks, and none of these procedures/options were discussed with me.the surgeon just said that it was a risky surgery and he could not guarantee anything! The big difference in anterior vs posterior hip replacement is primarily where the incision is made and how long it is. First, I am a little bit scared. There are potential drawbacks to anterior hip replacement. I am so sorry to learn that you have had such a bad experience after THR. What all this means for patients is a more optimum outcome and faster healing, which can reduce time interval to return to normal activities. You helped me tremendously in my research of the track record of my HMO, now I have one more quick question to run by you. Last summer I wiped out on my bike and snapped off the top of my right femur, with a diagonal break. Hip replacement is a surgical procedure in which the hip joint is replaced by a prosthetic implant, that is, a hip prosthesis.Hip replacement surgery can be performed as a total replacement or a hemi (half) replacement. You should feel good that you are aware of your fears and that it hasnt paralyzed you into not acting. The anterior hip can be easily and naturally recovered by walking, simple home exercises, and isometric exercises. These parts have a porous coating that the bone grows into. I wish you the best of luck with your care. Additionally, people with certain health conditions such as diabetes or heart disease may also not be good candidates. Can You Use An Inversion Table With A Hip Replacement 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. Testimonials Dr. Parsons has extensive experience in the posterior, anterior and superior (SuperPATH) approach to total hip replacement having performed hundreds of each. I have done everything I can think of to preserve my right hip, but sadly this too needs replacing. I have read your articles about procedures (anterior vs posterior). Its been a nightmare for me going into 4 yrs post op soon. Bleeding at the operative site can occur as a result of an anesthesia reaction, such as an allergic reaction. However, there are also some potential drawbacks to this type of surgery including a longer surgery time, a greater risk of blood loss, and a higher risk of nerve injury. 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. Click to enable/disable Google reCaptcha. I advise both my total hip and my total knee patients to avoid repetitive impact activities like distance running. There is less risk of neurological injury. The incidence of dislocations has further decreased over the past decade with our ability to implant larger size femoral heads. 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. The surgeon I am meeting with (Dr Jimmy Chow) is supposed to be top notch in this procedure, and I am just curious as to how different the surgery is from conventional surgeries. These positions include crossing your legs, bending your hip more than 90 degrees, or lying on your stomach. 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. There are many factors that contribute to whether or not someone is a good candidate for anterior hip replacement surgery. I would encourage you to discuss your concerns with you surgeon. In the right hands, both approaches do great. This can be dangerous because a piece of a clot can break off and travel to the lung, heart or, rarely, the brain. Get Directions, Phone: 954-489-4575 Yes, you do have increase risks. In my practice, patients who undergo a THR using a mini posterior or posterior approach: 1. I had an anterior approach hip replacement. Types of Hip Replacement (Approach) Hip replacements can be preformed through a direct anterior approach, an anterior lateral approach, a lateral approach, a posterior approach, and a superior approach. Traditional Hip Replacement - Traditional surgery requires a large incision of 10 to 12 inches and detachment of muscles from the hip. 2021 May 20;16(1):324 . Historically, higher dislocation rates were reported with the posterior approach, but it still was used for its many other advantages. I then would strongly suggest you trust that person to decide what approach and what prosthesis predictably will deliver the best results. If I have a 2nd revision of my right hip is it posterior approach or the mini-posterior approach as you discuss above? Can I expect any problems with the bilateral it was my choice. There is significantly less bleeding with the mini-posterior approach, notably reducing the necessity of a blood transfusion after the surgery. Procedures The most common reason or diagnosis that leads me to replace the hips of young women is hip dysplasia. Lastly, where can I find a great surgeon that takes FL Workmans Comp? There are various ways of doing a hip replacement. Some other methods are effective, but they are less effective for patients who leave the hospital earlier. I have two questions one, how realistic would it be to try to have both hips done at the same time? 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.. The SUPERPATHTM procedure provides a number of advantages over traditional hip replacement surgery. This risk is greatest in older females with bone of sub-optimal quality. Finally, I would choose a doctor with whom you connect and whose staff is engaged and knowledgeable. SuperPath brings some of the best benefits such as; earlier ambulation, no loss of strength, quicker recovery, less pain, decreased dislocation risk, and easier exposure for future revision surgery. 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 hope is that these new designs will, but time will tell. 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! Following surgery, the surgeon will devise a routine for the patient to engage in that is both comfortable and safe. Most doctors have and continue to implant hips through the posterior approach. 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. Every surgery should be done with as minimally invasive approach as possible taking into account these other critical factors. We can do this because of improved plastics. Even after the procedure is completed and the patient is on pain medications, pain and discomfort may occur in some cases. SuperPATH or Superior Approach To The Hip In Total Hip Replacement Because my husband has circulation problems in his leg and vein removed for open heart surgery last yearhis surgeon recommended the Mini posterior surgery. Use of the forums is subject to our Terms of Use I think it perfectly ok to discuss different approaches and ask for an opinion. Im considering this mini posterior approach. Also, when a single joint is replaced versus bilateral, there is significantly less bleeding and hence a much decreased need for transfusion. The art of surgery should mimic a well rehearsed ballet or symphony. Blood clots or bleeding. Although Superpath hip replacement is often a safe treatment, it may be associated with certain concerns, such as increased postoperative pain, as with any surgical procedure. The impingement can lead to a levering out of the ball from the socket. I am thoroughly confused at this point. As you can see, there are no restrictions. Im hoping to play tennis, go dancing and horseback riding once Ive healed. In my practice, I cement an Exeter stem in a significant percentage of my patients who undergo THR . 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 had posterior and much like the superpath trussed into the jig . I then stage the second surgery as early as 2 or 3 weeks post-operatively. Mine certainly have. The SuperPATH Hip Replacement: A Novel Less Invasive Radid Recovery 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. A major muscle is not cut during anterior hip replacement surgery, so pain is reduced and major muscles are not cut after the operation. 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. Advantages of an anterior approach to hip replacement A major muscle is not cut during the anterior procedure. 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. Also, since I am only 51, I am concerned about component longevity. I have cared for many patients over the years with significant heart and peripheral vascular disease. Once again, I think your decision to proceed with THR is the most reasonable. July played my last match when I buckled. I also would learn about the track record of the surgeon and hospital where you will decide to have the surgery and what implant will be used. The parts may be attached to the bones in one of two ways. I'm so encouraged to hear your successful story. Select a surgeon based on your impression of that individual: how engaged was he or she in your care, will you have access to that person as well as his or her team before and after surgery? Once again, it sounds as if you had a wonderful surgeon, which is the most important variable. I also have undiagnosed neuropathy in both legs from the knees down. Also, some body structures or anatomy makes approaching a hip anteriorly much more difficult than others. I wish you a full and speedy recovery. Also, because technically it is easier, many patients are being reconstructed with very short stems which are press fit into the bone during an anterior approach. Unfortunately, short of conservative and supportive measures, only time will tell. When the stem is placed in the femur, it still destroys the same amount of bone for implantation, regardless of which approach is used. I saw a surgeon who does the posterior approach only and will see another on 4/14/15 who does both approaches. SuperPath Hip Replacement Baton Rouge | SuperPath Surgeons Baton Rouge Note that blocking some types of cookies may impact your experience on our websites and the services we are able to offer. Pain and disability are reduced. Thanks again for this great blog! 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. Back then my surgeon advised me to perform a posterior surgery as opposed to anterior saying that I was overweight, short and a very muscular person and it would be easier and safer to do so. It allows the surgeon to work between the muscles and tendons without removing them from their anchoring points on the hip or thighbone. Have you ever performed the Mini on a patient 1 year after major open heart surgery? 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. A miniposterior approach uses the same intervals as the standard posterior approach but simply less tissue is released for the exposure. United States. The mini-posterior approach involves separating the muscle fibers of the large buttock muscle located at the side and the back of the hip. Having physio Need to choose, then select doctor based on that decision. An anterior approach hip replacement is one of the most minimally invasive surgical options for replacing a hip. 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. As a result of the interventions, the surgeon has a better view of the hip joint. It turned out to be more torn than they thought and they had to cut about a forth of it out. It helps the surgeon implant the acetabular component in a very precise position. The traditional posterior approach is the most commonly used in the United States and throughout the world (about 70 percent). 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 of 2020 only Dr. Leone is using the latest hip technique called the SPAIREtechnique where patients no longer have hip precautions after surgery. What surgical approach is typical for a complex total hip replacement? 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. Thank you so much for taking the time to inform us! Pam. 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. I wish you a full recovery. 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. SUPERPATH Hip Replacement | Bethesda Orthopaedic Institute 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. Going in for THR in July. Can you compare/contrast to the other approaches; posterior, mini posterior, anterior? 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. The hip joint can be supported by the socket, which is designed to fit over the ball and provide stability. Fax: 954-489-4584 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? Patient does not provide medical advice, diagnosis or treatment. Minimally invasive versus standard incision anterolateral hip replacement: a comparative study. We thank you for your readership. In addition, patients prefer the anterior approach due to the absence of pressure on the Femoral nerve in the anterior approach. Other health issues include congenital heart ASD corrected about 12 yrs ago with an amplatzer occluder implant by the right femoral approach resulting in possible femoral nerve compression, Lateral right leg numbness and leg discomfort since the implant, Groin pain and restriction in extending the right leg back has been a problem for some time and masked the fact that at least a portion of my increasing pain was from my hip. It is important that these medical and cardiac conditions be optimized by your PCP and cardiologist preoperatively. I would emphasize choosing your surgeon and not the approach. I am about 5 6 and 185 lbs, age 58, he did not think the weight was an issues. Your article is the first Ive read in which no muscle or tendons are cut in any approach other than the direct anterior approach. 5. I am looking at how many hips they have done and where they are doing them. They are encouraged to be very active and most stop using a cane, can drive their cars and are exercising in the pool, just two weeks after surgery. Gililand, our physician, explained the concept of health. I am allergic to narcotics .

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