disadvantages of superpath hip replacement

It is important to understand that "less invasive" does not only refer to the incision but . 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. I choose to do them in a staged fashion because it is a significantly shorter procedure (more than half time-wise) and some think this lessens the risk of infection. There are a number of different surgical ways (approaches) to access the hip joint. 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. 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. I would also like to know about the customized implant, as I havent yet heard much about it. Had arthroscopy in Jan 15, cleaned up tear and arthritis. I would recommend having an honest discussion with the surgeons you are considering. Would not make eye contact. The most important thing is to get a top notch surgeon and go with whatever approach they offer. Will meet with doctor soon but when I was finally able to really exercise after surgery I overdid it and developed plantar fasciitis. Again, trust your doctor. 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. Hard-on-hard bearings, such as ceramic-on-ceramic as well as metalon-metal articulations, also resulted in larger femoral heads being implanted. Everyone I know that has had both posterior and anterior surgery say not to even consider posterior. DAA and SuperPATH were equal in functional outcome and acetabular cup positioning. There is a chance that the hip will fall out of the socket, or that it will be levered out by twisting it. Clots can form in the leg veins after surgery. The first is that it is a major surgery, so there is a risk of complications such as infection. Long-term outcomes of SuperPATH approach need to be investigated. The following cookies are also needed - You can choose if you want to allow them: You can read about our cookies and privacy settings in detail on our Privacy Policy Page. It is much better to precisely release and cut rather than tear or fracture. The hip is replaced without the need for surgery to dislocate the joint. I know the most important decision you will make is choosing the doctor who will perform your surgery. If possible, try to get in writing any verbal promises made. An anterior capsule is the only soft tissue cut during this procedure to insert the implants. All have advantages and disadvantages. 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. Due to security reasons we are not able to show or modify cookies from other domains. 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. I suggest you discuss your concerns with your surgeon. Six weeks or longer is the exception. There is a possibility that blood loss may be reduced as there is less unnecessary exposed bone surface left to bleed. It is highly recommended that you avoid bending your hips and turning your feet together as part of hip precautions. By continuing to browse the site, you are agreeing to our use of cookies. Rather, they say Bill, please just do what you have to do and do a great job. I have since read that hips with this condition might get worse after labrum repair due to this structural defect. and Privacy Policy and steps will be taken to remove posts identified Fortunately, many folks who experience back symptoms before THR report improvement or resolution after. After reading your blog Im thankful he suggested this approach. 2 x week. Our insurance covers both. I am sure you should not listen to what I did!! Hip replacement is the second most common type of joint replacement, trailing only total knee replacement. If you would like a personal consultation, please contact our office at 954-489-4575 or by email at LeoneCenter@Holy-cross.com. This is particularly true if the person is overweight, has very muscular thighs or is short. SuperPath is a portal assisted THA approach that accesses the capsule superiorly through the interval between the gluteus medius and piriformis without requiring the cutting of any muscles or tendons. We are an online blog dedicated to providing comprehensive and accurate information about orthopedics and injury prevention. Your surgeon will know better than anyone else just how stable your new hip is immediately after your surgery and how securely the surrounding tissues were repaired after the reconstruction. If you do not want that we track your visit to our site you can disable tracking in your browser here: We also use different external services like Google Webfonts, Google Maps, and external Video providers. Mini posterior refers to the approach or tissue interval the surgeon uses to implant the Total Hip. Behavior. In some individuals, it takes much more force and dissection in order to accomplish this (typically, there is significantly more bleeding from an anterior approach compared to a mini-posterior approach). Im pleased that you will be coming in for an appointment. Posted What Ive been able to achieve is find two nerve supplements that have taken away the burn/tingle on my thigh. Fortunately, the incidence of hips dislocating after THR is very small, especially after first-time hip replacement. In 2013 I had a THA done on the left hip. 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. Always speak to your doctor before acting and in cases of emergency seek There are a few complications that can occur with anterior hip replacement surgery. I believe choosing your physician is the most important decision you can make. The SUPERPATHTM procedure provides a number of advantages over traditional hip replacement surgery. 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. Conclusions SuperPATH approach showed better results in decreasing incision length and early pain intensity as well as improvement of short-term functional outcome. What is most important is that you find a surgeon who understands the particular complexities with your problem and whom you trust. I would discuss fully your goals and concerns. Bleeding at the operative site can occur as a result of an anesthesia reaction, such as an allergic reaction. It does sound as if proceeding with a THR is appropriate, since your attempt to repair the joint arthroscopically did not pan out. If your surgeon did a great job, that is something to respect. We have to get ok from cardiologist and get ekg, chest xray, etc. Would appreciate any input you might have on the auto immune issue, and weight etc. We now have less-invasive techniques, better surgical methods of closing soft the tissue and more experience. Hip anatomy 3. What are your thoughts on the use of robotics? My main concern is that I have a tilted sacrum and a very sway back. Before proceeding, it is a good idea to review the recommendations and specific parts that your surgeon may recommend. We provide you with a list of stored cookies on your computer in our domain so you can check what we stored. . During anterior approaches, fracture repair is much more difficult and necessitates the use of a separate incision. 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. Is it really as good as it sounds? Finally, because my patients are walking the day of surgery, most want to go home rather than to rehab. This treatment is commonly recommended for patients suffering from osteoarthritis of the hip. My question is, I am a very active 67 yr old. I am 37 and have suffered from AVN since I was 14. 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. Patients can also have as little as a 3-inch incision. I believe going home is very therapeutic and often safer. In 2014 I had to do another THA, this time on my right side. Thank you for sharing. My advice would be to avoid the extremes of any motion that exceed your hips ROM. I can still do 30-45 mile rides, but I need to take something before each ride, because of the undone left hip. Can you explain it to me as he didnt go into detail. My first bike ride was 22 miles without any problems. 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. That being said, if the foot is now a much bigger problem than the hip, you may have to deal with that first. Click to enable/disable Google Analytics tracking. Both have valid cons against the others methods and pros on their method. I have had problems with my hip for the last several yrs. Walker to get around. Superpath total hip replacement animation. We may request cookies to be set on your device. My husband, who is only 35, has to consider a THA in the near future and Im very torn over which approach as the surgeon we really like dos a posterior but I am concerned about dislocation rates in posterior vs anterior. He treats a variety of hip, knee, and shoulder conditions, and performs hip and knee total joint replacements. Most patients after a bilateral procedure would not go home but rather a rehab unit. Fax: 954-489-4584 As you can see, there are no restrictions. Once it exceeds this ROM, impingement occurs. Thank-you. Hip replacement surgery is typically performed in a hospital and requires at least one night in the operating room. 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). 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. Risks associated with hip replacement surgery can include: Blood clots. 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. Im now 6 weeks out and doing good. A ceramic-on-ceramic bearing is also a very good bearing. Because visualizing the femur is easier, an experienced surgeon can choose the most appropriate femoral implant rather than just the one that is easiest to implant, taking into account the patients bone quality, activity level and age. Unfortunately, short of conservative and supportive measures, only time will tell. We fully respect if you want to refuse cookies but to avoid asking you again and again kindly allow us to store a cookie for that. Traditional Hip Replacement - Traditional surgery requires a large incision of 10 to 12 inches and detachment of muscles from the hip. I wish you a full recovery. It's cut off and removed through the hole. I would not recommend pushing your surgeon to use one specific approach or another. For the prevention, diagnosis, and treatment of hip pain and other problems affecting your hips, call Advanced Sports Medicine Center today at (941) 957-1500. If your little voice is questioning if you are overdoing it or hurting yourself, then listen to it and ease up. The surgical technique for a SUPERPATH Hip Replacement was developed as an advancement to traditional total hip replacement. You can check these in your browser security settings. Some of the most common considerations are age, weight, activity level, and the presence of other health conditions. Historically, higher dislocation rates were reported with the posterior approach, but it still was used for its many other advantages. External rotation of your feet should be limited (avoiding them twisting to the outside as Charlie Chaplin does) and hip hyperextension should be avoided. The incision made for the operation can be as small as three inches. If the tissues are traumatized and / or the final components are not optimally positioned, then it certainly is not an advantage. Check to enable permanent hiding of message bar and refuse all cookies if you do not opt in. An anterior hip replacement is not covered by a specific credential system for orthopedic surgeons. 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. I think there may be increased associated complications. In anterior and posterior surgeries, the outcome is essentially the same a new hip. Because my husband has circulation problems in his leg and vein removed for open heart surgery last yearhis surgeon recommended the Mini posterior surgery. 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 wrote to you in January, now my surgery is in a couple of weeks. . But this blog was a nice nudge toward the posterior. Many wonderful physicians are part of various HMO panels. What are the risks involved? The only problem Ive had post hip replacement is some on/off again groin pain. The SUPERPATH technique is a tissue-sparing procedure. Often in this group of patients, their X-rays show only minimal cartilage space compromise (it may appear thinned and irregular) and I observe at time of surgery that the labrum appears hypertrophied (to compensate for lack of head coverage) and often torn. Also, the surgeon said that I would end up having one leg shorter than the other is this true? My legs are very muscular and trim. Diagnosed possible labral tear. Remain upright . Once again, I think your decision to proceed with THR is the most reasonable. How do you ask your doctor the questions you want to ask? Does it really not matter which approach I have, posterior or anterior? Do I have a risk of fractures during a posterior right hip revision due to my prior complications already? We thank you for your readership. Does my prothesis not last as long since I am now doing a 3rd surgery? But I feel that time could be lost and all my symptoms may become irreversible. Its been my experience that femoral nerves tend to recover more readily than sciatic nerves. Once again, it sounds as if you had a wonderful surgeon, which is the most important variable. 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. An anterior hip replacement procedure, on the other hand, performs the same function as an anterior hip replacement in terms of tissue shaving. I also regularly receive Rolfing treatments which has helped me manage pain and maintain what mobility I have. I have not seen this before because in the past, the complication from hip surgery were sciatic nerve injury from posterior approach. The anterior approach has a lower incidence of sciatic nerve injury and a higher incidence of femoral nerve injury. There is no way that you can recover fast from having bones cut and shaped and large metal objects inserted into them. 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. 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. 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). They thought surgery to repair it would give me about 5 yrs. 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. 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? Its been six months since surgery, my operating doctor keeps feeding me with lets wait another month stuff. I advise both my total hip and my total knee patients to avoid repetitive impact activities like distance running. I would anticipate that you would be able to return fully to your activity once the tissues around your total hip heel. It requires surgical insight and skill to accomplish. I have been doing ALOT of research about the different approaches to THR and looking for the absolute best surgeon. I am 5 weeks out and have been doing beautifully! My husband has a plastic valve (done in 86) and synthetic assending aorta and triple bypass (done in 2013)very successful surgery. I do not do hip arthroscopy. I am feeling like this is a business like everything is else. 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. 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 Individual results and activity levels after surgery vary and depend on many factors including age, weight and prior activity level. 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. Thanks. Patient Concerns In a posterior hip replacement, the procedure is done on the side of the hip. Hello Dr Leone, An artificial joint is used to replace the worn out hip joint during a hip replacement procedure known as posterior hip replacement. I typically do hip replacement on the get anterior approach in 90% of my patients. If they did develop five months post-op, then you have to consider that it could be a manifestation of back pathology compromising a nerve root. Initially I was hesitant of THR thinking I was way too young for something so drastic but Ive now been miserable enough long enough that I am welcoming the idea of surgery. Length of hospital stay with SuperPath hip replacement approach. We are always refining and trying to make it better. In addition, patients prefer the anterior approach due to the absence of pressure on the Femoral nerve in the anterior approach. Gililand, our physician, explained the concept of health. There are a few disadvantages to hip replacement surgery. SuperPath hip replacement is a newer method and has been used since 2019 at Leicester's Hospitals. When studying the hospital credentials, try and learn how many joint replacements are performed at that hospital each year, their infection rate and their 30-day readmission rate. I am scheduled to have total hip replacement surgery in 2 weeks. Can You Use An Inversion Table With A Hip Replacement Also congenital pulmonary hypertension (PA pressure about 52) and have hashimotos hypothyroid, and two additional auto immune issues ( alopecia and psoriasis of feet),and hypertension. The experiences will vary greatly . I find it curious that you report having a good result for the first five months after your surgery as this suggests that the surgery was done for the right indication, i.e., you did well and were pleased for the first five months after THR. This is actually a good sign. Gary. A hip replacement is a common type of surgery where a damaged hip joint is replaced with an artificial one (known as an implant). Personally, it I were caring for you, I would have advised you exactly as the orthopedic surgeon who took care of you did. Not only was my recovery twice as fast with the anterior, there was very little pain in comparison. Comments about life-long hip restrictions between Posterior, Anteriorlateral and Anterior approaches? Being cared for in a hospital that specializes in joint replacement and has an extensive specialty medical staff also is key. Did you have the surgery via Superpath method? 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. Adductors refer to a group of muscles that insert into the medial (inner) upper femur and often become contracted with an arthritic hip. Im 51, 59 and 148 and want to get back to tennis etc, this has been long frustrating process. I also have undiagnosed neuropathy in both legs from the knees down. It typically requires a 4 to 5 day hospital stay, 3 to 6 month recovery period . 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. Many people seek anterior hip replacement due to the unbearable pain they feel in their hip joints. In my experience, the restrictions (or those positions we ask our patients to avoid after surgery) have become much less limiting and are off limits for a much shorter period of time. I think its vitally important that you go into surgery truly believing in your heart that you are going to do well, and that you are with the best surgeon and team who will help you. Third, the procedure is shorter in length and requires less hospital stay than traditional hip replacement surgery. But this will always prompt you to accept/refuse cookies when revisiting our site. 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? I was told to wait 6 weeks before I resumed my exercise regiment. The surgeon I expect to use does the Direct Anterior approach. Ten years ago I had total hip replacement on the left at hss. The bone isn't dislocated in surgery. Still going to rehab to reduce stiffness and increase strength but I am in better shape now than before surgery. The most important variable is how quickly the person is motivated to return to work. It also keeps the surrounding muscles and tendons in place to reduce the risk of post-op pain and nerve damage. I will let you in on something personal. I have written to you to learn what are the surgical considerations for someone with shallow hip sockets like mine. Your blog on anterior vs posterior approach was very informative. [QxMD MEDLINE Link]. SuperPath approach is the least invasive due in part to the minimal amount of tissue damage. The mini-posterior approach involves separating the muscle fibers of the large buttock muscle located at the side and the back of the hip. Also, is it immoral for an 80 year old to have THR and cost the nations health care system $25 $35k? Most traditional hip replacement models are metal-on-plastic varieties. 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. Share your concerns with your surgeon. Unfortunately, injury to the lateral femoral cutaneous nerve is a common complication after the anterior approach for hip replacement. Many manufacturers are responding to the surgeons desire for shorter stems and many are now available on the market. I am temped to wait but it is getting worse. 1000 NE 56th Street, Less tissue damage during surgery allows for a much faster recovery and no restrictions in range of motion when compared to traditional hip surgery. Every hip implant has benefits and risks. I am scheduled for bilateral hip replacement at the end of August. Reconstructing the opposite hip hopefully will result in legs that feel more equal. I have seen 2 doctors one doing posterior, the other anterior. The pain I get is in the groin and a sharp pain in the buttocks, that feels like muscle pain. The bone isn't dislocated in surgery. Ive since met 3 others who ended up with the mess that Im dealing with also. Problems such as osteoarthritis, rheumatoid arthritis and avascular necrosis can destroy the protective cartilage around the hip joint, disrupting the smooth contact between the femoral head (ball) and hip socket. These stems are a new design, and therefore do not have an established track record. The size of the incision is determined by how large and tight the hip/thigh is and how much tissue (fat and muscle) exists between the bones of the hip and the overlying skin. Also, I am diabetic and have had two organ transplants and am extremely worried about infections, etc. 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. Does either procedure in this discussion present restrictions or advantages for this sort of movement? 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. In bed for long periods with little or no movement. Blog results, I decided to see and orthopedic doctor was advised to have THR. It would be interesting to hear what you have to say Doug. Try our Symptom Checker Got any other symptoms? Doc says once recovered I should avoid flexion with adduction and internal rotation. Understand that every total hip, no matter which approach is used to implant it, has the potential to dislocate. Thank you. I have a tilted sacrum, sway back and a very large posterior. I do not have dials and no one seems to know where the neuropathy stems from. There are potential drawbacks to anterior hip replacement. In my experience, people recover from femoral nerve injures more frequently and completely than from sciatic nerve injuries. The SuperPATH technique is arguably the least invasive hip replacement technique. The SuperPath procedure was designed to replace the joint while sparing as much tissue as possible, substantially improving patients' recovery time. I wish you well. Thank you for this! (PATH) and Supercapsular percutaneously assisted total hip (SuperPATH) arthroplasty: learning curves and early outcomes. Finding the right surgeon is critical, because your care is about so much more than just fixing your hip. Potentially there also is less pain and a quicker recovery. Why would the doctor not have that at their finger tips? When a patient feels better, they can return to work almost immediately, though it usually takes two weeks or longer. General comments will be answered in as timely a manner as possible, Hip & Knee Surgery It normally takes about 3-6 weeks to resume normal household activities and about 12 weeks to resume recreational activities like bicycling or golfing. Possible Infections Dr. Sutphen: A minimal number of surgery patients (roughly around 1%) can develop an infection around their hip replacement. respect of any healthcare matters. You are to be commended for taking the time to answer our questions. Again, considering my own practice, I routinely see my patients recover faster and easier after their second hip or knee replacement because they are more confident having had a good first experience. All: Nobody wants a long recovery. As of 2020 only Dr. Leone is using the latest hip technique called the. I am an obese female and will be 62 in February. Thank you, out the next afternoon and using a walking stick from day 2 to day 10 when I ditched it altogether . The mini-posterior is considered a more straightforward approach then the anterior, resulting in lesser complication rates. Publications Advantages of this procedure include: The direct anterior approach involves dissecting between the natural intervals of the two main muscles located at the front of the hip and upper thigh. As a result of the interventions, the surgeon has a better view of the hip joint. Being out of bed and moving soon after surgery adds to a patients safety and speeds the recovery. 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