disadvantages of superpath hip replacement disadvantages of superpath hip replacement

As noted above, because the femur is difficult to visualize, component positioning, sizing, and stability are more likely to be compromised. If was 3 weeks after discharge What do you mean by painful anterior scarring and soft tissue exposure and trauma? This risk is greatest in older females with bone of sub-optimal quality. My physical life is diminished. According to Dr. Rosen, the most important thing to remember is what you leave behind rather than how you get there. Proponents of minimally invasive hip replacement say small-incision operations can lessen blood loss, ease post-operative pain, trim hospital stays, improve scar appearance, and speed healing.. You can also change some of your preferences. 3. Apples to apples which procedure has the lowest incident of complications? In severe cases, I will use my patients own femoral head, which is removed as a bone graft to help stabilize the new cup and garden new bone for the future. While new techniques, instruments and prostheses have been developed specifically for minimally invasive surgeries, there are many well-established approaches to hip replacement. Until now. Hip replacement is a fantastic operation that can help relieve pain, improve daily function, and improve quality of life. The anterior approach, as opposed to the lateral or posterior approach, uses a small incision in the front of the hip. The SUPERPATH technique is a tissue-sparing procedure. It is important that the individual who ultimately implants your next THR uses the approach which he or she feels comfortable with and has the best chance to deliver the optimal result. In my experience, after four to six months most patients simply return to normal activity. According to Dr. Gililand, patients should not try to change their surgeons opinion based on their preferences. (PATH) and Supercapsular percutaneously assisted total hip (SuperPATH) arthroplasty: learning curves and early outcomes. I play in the 50s age group. Often, as the labrum is torn, it leads to a lifting off of hyaline articular cartilage where these two tissues meet, called delamination. 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. Your out-of-pocket costs for your hipreplacement will be impacted by a number of . Thanks. During the procedure, the patient must have a small incision made in the side of his hip. Dont let PR marketing confuse the big picture. In hopes that THA would let me live my normal life without arthritis, instead I can barely walk more than 100 yards without having to stop, my gait is crooked causing lower back problems and my personal life is less than perfect. Being cared for in a hospital that specializes in joint replacement and has an extensive specialty medical staff also is key. What is most important is that you find a surgeon who understands the particular complexities with your problem and whom you trust. 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 wish you only the best. What are the risks involved? My question is: should I just tolerate the pain and limp, or take a chance with the hip replacement. Again, trust your doctor. I am planning to have a THR this summer. The nerve which supplies sensation to the front and side of the thigh is vulnerable. Thank you. Like you said, consistent outcome is important and this surgeon is excellent and I have great faith in him (Im a physical therapist and see his patients post-op so get to see the, at least short term, results myself). SuperPath approach is the least invasive due in part to the minimal amount of tissue damage. Or are x-rays definitive for determining the exact reason for THR? I advise both my total hip and my total knee patients to avoid repetitive impact activities like distance running. Does this mean my body may reject the metal of the post or cup? The questions youre asking are 100 percent appropriate. Ive done PT and plan to continue working on strengthening my core and flexibility of those large muscles. There are a number of different potential surgical approaches available for hip replacement, each with their own potential advantages and potential drawbacks. Thank-you. Because of the concerns of posterior dislocation, in the past patients were taught certain positions to avoid. Cant afford a dislocation or other complications cause Im sole caregiver for severely handicapped son. Your frustration is completely understandable. My advice is to have a frank discussion with your surgeon and share these concerns. Which approach did the doctor take? I spoke in person to probably 4-5 of his success patients and went with hearing from them. I then stage the second surgery as early as 2 or 3 weeks post-operatively. If I do a single hip or knee replacement, that patient is out of bed standing and, in most cases, walking the afternoon of surgery. I 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. 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. Pain modifying drugs as well and as a course of NSAIDs might also be appropriate. It is much better to precisely release and cut rather than tear or fracture. My doctor does not do mini posterior, therefor I have a 6 incision. My acyive 60 year old husband is scheduled to have Mini posterior total hip replacement in 6 weeks. It is important to understand that "less invasive" does not only refer to the incision but . I have written to you to learn what are the surgical considerations for someone with shallow hip sockets like mine. Can I make an appointment with you. As of 2020 only Dr. Leone is using the latest hip technique called the SPAIREtechnique where patients no longer have hip precautions after surgery. I just want to thank you for the information on this site. I wish you a full and speedy recovery. Mine certainly have. I understand that most surgeons now do a spinal rather than general anesthesia. No i just had the posterior method which has a larger incision. Dr. Robert Sigmund is a board-certified orthopedic surgeon and a sports medicine physician based in St. Louis, Missouri. I wish you luck on your journey. Will I still be able to do the things I like to do? I am a competitive tennis player in my age division. In May of 2015, I had a Labial tear repaired. I think seeing several surgeons for different opinions is good judgment. Dr. William Leone, Hello Dr. 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. If the tissues are traumatized and / or the final components are not optimally positioned, then it certainly is not an advantage. In the dark to find out about this myself. I am about to have a hip replacement and would like to know what kind of limitations Ill have afterward. 2015 Aug. 3 (13):179. The posterior approach for hip replacement surgery is by far the most common surgical technique used in the United States and throughout the world. If you would like a personal consultation, please contact our office at 954-489-4575 or by email at LeoneCenter@Holy-cross.com. 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. Mini posterior refers to the approach or tissue interval the surgeon uses to implant the Total Hip. Publications 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. Length of hospital stay with SuperPath hip replacement approach. One of the biggest changes that Ive seen in my practice over the past 25 years is how quickly patients get well and go home. Consult an orthopedic surgeon who specializes in hip replacement surgery if you have a hip problem. Fort Lauderdale, FL 33334 A hip replacement can greatly reduce the pain associated with arthritis of the hip, with almost all patients having complete or near-complete relief. Its been my experience that femoral nerves tend to recover more readily than sciatic nerves. This treatment is commonly recommended for patients suffering from osteoarthritis of the hip. 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. About my surgery: I had to wait 30 hours before surgery, two days later I was released, within two more days I stopped using my walker. Dr. Tom Miller gives you the five best options for hip replacement surgery. Ten years ago I had total hip replacement on the left at hss. My strategy is to make as small an incision as possible, but one that allows for excellent exposure and reconstruction without brutalizing the tissues. How the soft tissues are handled and respected, the patients expectations before the surgery and the surgeons experience do. Patients can also have as little as a 3-inch incision. Original Medicare (Part A and Part B) will typically cover hip replacement surgery if it's medically necessary. When a patient feels better, they can return to work almost immediately, though it usually takes two weeks or longer. Not wanting to go through all the restrictions, I was considering anterior for my right hip, which would require not having it done locally since doctors here have been doing it for only 1 year. My surgeon does the SuperPath method. You can be successful by staying healthy by sticking to less pain. Irrespective of the approach that is used to implant the prosthesis, the tissues that surround the new prosthetic hip must heal and mature if the hip is to achieve stability. About this injury to me. They thought surgery to repair it would give me about 5 yrs. In my experience the approach used to replace a hip does not effect how quickly a patient recovers. This surgical procedure is performed with a patient lying on their side, and a surgical incision made along the outside of the hip. 4 mts later am using 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. My husband has a plastic valve (done in 86) and synthetic assending aorta and triple bypass (done in 2013)very successful surgery. This technique is also referred to as the . What is SuperPath hip replacement? I wish your patient well. We need 2 cookies to store this setting. Thank you for this! I would discuss fully your goals and concerns. 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. Im ready to have the surgery, having been basically bone on bone for several years. But I am now in chronic low grade pain thats getting worse and dont know what I should do. Dear Dr. Leone, daniel neeleman net worth . Most individuals who have had total hip replacement surgery fall into this category and simply resume their lives.. Here is his perspective based on careful observation of outcomes. 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. Each question is scored from 1-5, with 1 being no problems and 5 being severe problems. Better luck to you all. The initial recovery period typically takes six weeks or more. A major hip replacement can take up to four months to fully recover from. Also, how about hip restructuring instead of Total Hip Replacement. The first is that it is a major surgery, so there is a risk of complications such as infection. Will meet with doctor soon but when I was finally able to really exercise after surgery I overdid it and developed plantar fasciitis. Having a THR is a major undertaking and it is reasonable to expect the hip construct to function optimally for twenty and more years. That being said, if the foot is now a much bigger problem than the hip, you may have to deal with that first. As a result, patients can return to their normal activities much sooner than if they had had traditional hip replacement surgery. Changes will take effect once you reload the page. The bone isn't dislocated in surgery. What is your experience and take on this ? I would like your opinion on the stem cell injections as I am really afraid of the second surgery on the same side of my body. I have/had arthritis in my hips. Because the muscle fibers are separated, not cut, the nerve path is not disturbed and the muscle is not injured. A long surgery time, on the other hand, was also associated with DAA. I am so sorry to learn that you are struggling. 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. Do you have any thoughts on this issue? The most important thing is that tissue is handled gently and trauma is minimized, whichever approach is used. Many wonderful physicians are part of various HMO panels. Diagnosed possible labral tear. This is not true for bilateral cases. Dear DR Leone, Going in for THR in July. There has been an increase in the range of motion. Celle said: Superpath may give you a faster early recovery, but whatever method is used, recovery is still going to take a long time. My advice is to consult with your surgeon regarding how stable the replaced hip is and the most appropriate rehab to follow post-operatively. Read our editorial policy. I wish you the very best, Posted I typically do hip replacement on the get anterior approach in 90% of my patients. Potential Disadvantages of Anterior Hip Replacement Anterior hip replacement does have a few limitations: There may be wound healing issues Research suggests that people who undergo anterior hip replacement may be more likely to have a problem with wound healing, particularly infection. It is important that the individual who ultimately implants your next THR uses the approach which he or she feels comfortable with and has the best chance to deliver the optimal result. 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. I often suggest to my patients that they speak to other patients for whom Ive cared and to whom they can relate to learn about their experiences. Help. I weigh 185 and am 54 and realize its ideal to lose weight prior to surgery (working on it as always). The bigger the ball, the bigger the ROM without impingement and the bigger the jumping distance that would be required for the hip to dislocate. There is a 1-2% risk of fracture of the femoral neck. I am a 55 year old with a labral tear and moderate arthritis. Patients mobilize the day of surgery and typically go home the next day. THOUGHTS? It is possible that you will be required to avoid certain high-impact activities to protect your new hip. There is also a risk of the hip joint not fusing correctly, which can lead to pain and instability. This is described as a posterior approach because the actual hip . I think the money you spend to have a hip replacement is more than just moral or justified, it is smart business. After all, no matter the age, it will determine the likelihood of maintaining your mobility and independence. 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 normal to want to recover quickly and return to a very active lifestyle without pain. 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. So im going back to the surgeon that did my left hip and left me in agonizing pain for 2 months after procedure. When people loose independence and mobility, not only does the quality of life suffer, they are much more likely to develop a myriad of medical problems requiring even more-expensive and/or long-term care, including loss of independent living. I also would find out your surgeons recommendation regarding activities and restrictions. Historically, higher dislocation rates were reported with the posterior approach, but it still was used for its many other advantages. Part of those possibilities includes a better and more comfortable sex life. As you can see, there are no restrictions. Why is that? [QxMD MEDLINE Link]. Walker to get around. The most important variable is how quickly the person is motivated to return to work. Should one of these events occur during a mini-posterior procedure, they are easier to recognize and correct. Most patients after a bilateral procedure would not go home but rather a rehab unit. He is well known as a top doc for 20 yrs & I was persuaded because the mini posterior has less chance of nerve damage & the surgeon has more options for types of spikes, which your article explains well. I was told to wait 6 weeks before I resumed my exercise regiment. Had a total hip replacement aug 2013. Dr. Studying a hospital and physicians track record before you commit is important. Traditional hip replacement surgery is no longer an option, but it is less painful and has a number of advantages. Hip replacement surgery is typically performed in a hospital and requires at least one night in the operating room. Even in my practice, which is starting its 27th year, we continue to refine the surgical procedure, pre- and post-operative instructions and rehab (this is huge), pre- and post-operative pain management, and even anesthesia. 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 is important that these medical and cardiac conditions be optimized by your PCP and cardiologist preoperatively. Dr. William Leone. This suggests that something changed after five months. I had an MRI by a different hip doctor (a preservationist) who diagnosed me with a birth defect (hip dysplasia). They may be: Cemented to the bone. Thank you for sharing. The most common reason or diagnosis that leads me to replace the hips of young women is hip dysplasia. Introduction Lateral femoral cutaneous nerve injury is the most common injury incurred during an anterior approach. I feel that at 10 weeks with profuse denervation potentials on the quad muscles, the prognosis is not good, even at 6 months. A hip replacement is the most common cause of complication in about 20% of cases. Hip anatomy Because of the restricted view provided by the anterior incision, the anterior incision is a technically demanding procedure. There are risks and recovery times associated with surgery. Super path appears to come with it's hazards due to bone sawing rather than dislocation of the hip to be replaced, making revision much more difficult if issues occur later down the line. In my practice, patients who undergo a THR using a mini posterior or posterior approach: 1. Does anyone ever attempt to do both at the same time if THR is determined? What is the best stem and ball/socket combo to use for someone that ones to play tennis? Thanks! Is AL better than P for this? From what Ive seen, most THR patients dont need very much PT, although I do encourage exercising in a pool. I think it perfectly ok to discuss different approaches and ask for an opinion. Fortunately you live in a part of the world where there are many capable orthopedic surgeons. I am having the mini posterior done in June and my surgeon gave me the pros & cons of both. Some patients who have recently had anterior hip replacement may suffer from complications such as wound healing. Get Directions, Phone: 954-489-4575 It is generally agreed that the temporary numbness is more than balanced out by the substantially improved recovery, reduced pain, absence of a limp, faster return to function, and virtual elimination of the risk of hip dislocation. Its reasonable to inquire about his or her experience using the Mako robot. I was not aware that any of the local surgeons who is doing anterior approach. This left hip remained tender based on my exercise level which I did modify but always my hip had some soreness. No Muscles Cut is for billboards. Dr. William Leone. The healing and maturation of this tissue takes time. Thank you so much for your answer, I appreciate your taking the time to care about others. If a revision were necessary, even more bone must be destroyed to remove it. I wrote to you in January, now my surgery is in a couple of weeks. Pam. Many others feel the same. Intervals between muscles are separated or muscles are separated in line with their fibers without injuring the muscles innervation. Ken. A modern artificial hip joint is designed to last for at least 15 years. Sometimes the pain goes away as I walk and sometimes it doesnt. more nutritious, too. The first surgeon never mentioned this condition at all. SuperPATH is a micro-invasive method of performing a standard total hip replacement where the surgeon utilizes a smaller initial incision and, more importantly, a very limited dissection in the deep tissues. Can you suggest any pain medication that would not interfere with anti rejection drugs? disadvantages of superpath hip replacement. Hello Dr. There are a few complications that can occur with anterior hip replacement surgery. Rather, they say Bill, please just do what you have to do and do a great job. This effectively moves the hip joint center, toward the bladder or midline, and improves hip mechanics. Doc says once recovered I should avoid flexion with adduction and internal rotation. However, some offer greater patient benefits than others. It can lead to numbness in the thigh and, in rare cases, skin irritation due to the nerves presence. But this blog was a nice nudge toward the posterior. These positions include crossing your legs, bending your hip more than 90 degrees, or lying on your stomach. Traditional Hip Replacement - Traditional surgery requires a large incision of 10 to 12 inches and detachment of muscles from the hip. Consuming excessive-fibre and wholegrain meals will assist to keep you feeling full, and will be We want the forums to be a useful resource for our users but it is important to remember that the forums are Hip replacement currently consists of two major approaches: direct anterior and anterior approaches. The big difference in anterior vs posterior hip replacement is primarily where the incision is made and how long it is. Long recovery but all is well. By far the most important variable is the doctor who is doing your surgery and managing your post-op care. I would encourage you to discuss with your surgeon the difficulties and pain you experienced after the first surgery, and together explore if another plan can be created for a better outcome the second time around. I wish you well. Your primary goal should be to find a surgeon in whom you trust and who will take the workmans compensation insurance. Had arthroscopy in Jan 15, cleaned up tear and arthritis. Because I have scfe also in my left hip, I will have to have it fixed too. Felt very uninformed and left The femur is prepared with the head and neck intact reducing the chance of fracture. I had the mini posterior approach done and it gets better everyday. 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. 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. Because the patient is lying on his back, it facilitates using a fluoroscope or moving x-ray throughout the procedure. I have never operated on another surgeon who asked me to make as small an incision as possible or use the minimally invasive approach. The leg lifts really aggravate the front of the hip. Yes, you can do very well. Some surgeons believe that a patient who is neither obese nor overly muscular is a good candidate for anterior hip replacement surgery. Because these cookies are strictly necessary to deliver the website, refusing them will have impact how our site functions. Your symptoms still sound mechanical, positional and episodic. Most patients are able to walk the day of surgery. We provide the best cash prices and customer care in the industry. Is it really as good as it sounds? Dr. William Leone. A hip replacement is a common type of surgery where a damaged hip joint is replaced with an artificial one (known as an implant). I am experiencing pai. The art of surgery should mimic a well rehearsed ballet or symphony. With a significant learning curve, it is likely that you will have to replace about 100 hips before you are truly comfortable with the approach. Some surgeons will use 2 incisions, both the anterior and superior approach. I tore my labrum at age 43 and only discovered then that I had bilateral dysplasia. Some in the early period have good track records, others do not. She never though mentioned an increased risk of damaging femoral cutaneous nerve or possible muscle damage that would turn into improperly heeled muscle as a result. This is because the nerve is located in front of the hip. SuperPATH showed better results in decreasing operation time, incision length, intraoperative blood loss, and early pain intensity. Potentially there also is less pain and a quicker recovery. We are always refining and trying to make it better. What are the experiences of other countries with THR? United States. Clearly, he or she has earned your respect and confidence. Ultimately, you and your surgeon should discuss all procedures and technologies available and then trust that your surgeon will choose the best course of treatment and surgical procedure for you. Supercapsular Percutaneously-Assisted Total Hip surgery or SuperPATH surgery is a novel method of hip replacement where your surgeon can perform total hip replacement through 2-3 inch incision into the tip of the hip and without dislocating the hip or damaging the surrounding soft-tissue (muscles and tendons). Disadvantages of the anterior approach include: The nerve which supplies sensation to the front and side of the thigh is vulnerable. All of these releases may be necessary as part of the surgery and patients do well. For centers like Phoenix Spine and Joint that use a robot, there is . You should consult with your doctor before deciding to have an anterior total hip replacement. Click to enable/disable Google reCaptcha. Hips that are out of joint have an anterior hip replacement. We can do this because of improved plastics. The surgeon does about 200 a year and people say he has a good reputation. Gary. I understand and respect that many surgeons prefer doing them simultaneously. A lot of hospitals and ambulatory surgical centers offer what's called outpatient surgery. Im hearing no restrictions (once recovery is done) for Anterior, but always some for the other two. 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.