Hip replacement surgery is one of the most successful procedures in medicine. My concern is that one says, for my situation, it has to be done from the posterior. Ivy Brooke Hayes from Florida shares her thoughts about having a bilateral total hip replacement at Mayo Clinic in Arizona. Cartilage is a tissue that helps joints move. At 5 years both implants failed and required revision, which the second surgeon did 6 weeks apart, posterior. Hi, @JustinMcClanahan Thanks for moving my post to the proper category. There are several approaches to the hip joint that can be utilized for total hip replacement and these include with some variations the posterior approach (Moore or Southern), the lateral approach (Hardinge), the anterolateral approach (Watson Jones), and the direct anterior … A nurse friend just told us that she would never have the posterior surgery as the healing time is so much longer. 2017 I had total hip replacement anterior approach. “I haven’t even been able to walk to the mailbox because my hips hurt so much. I know there are no promises in surgery but it sure would be nice if the docs themselves really looked at each case and brought up the various points instead of a patient having to try to remember what to ask — so they aren't surprised at the outcome. The one who would use the anterior approach also does do posterior and has for about 14 years. I had the first one eight years ago. I did this so the members already discussing this topic would see your message and so that you could read some of their previous posts. Another surgeon ready to do posterior. Each member may be able to share a bit about the discussions they had with their surgeon and their experiences with the approach that was used. What I...", "Thank you. 2016 I had total hip replacement via posterior approach. Ed, were you a candidate for either approach? Cartilage is a tissue that helps joints move. Watch Derick Johnson, DO, The Bone & Joint Center in Holland, Michigan and anterior approach hip replacement surgery. This technique involves cutting through muscle in the back of the hip to access the hip joint. Las Vegas, … Adult Reconstruction Fellowship. He had one THR a few years ago – posterior. Will be having a pre-op dr appt in a few days. This technique allows patients to recover and return to activities and work quickly. Las Vegas, Nevada 89149. I spent a week with a walker. This is not necessarily a bad thing, you want your surgeon confident in their method. “Everything was just superior,” she says. If you have had a relative who got a hip replacement several years ago, chances are it was a posterior surgery. I know each doc has his/her preferences, but I would like to know what is best for MY situation. In a Grand Rounds presentation, Richard C. Daly, M.D., a cardiovascular surgeon at Mayo Clinic, discusses the robotic approach to repair of mitral valve regurgitation related to leaflet prolapse (degenerative mitral valve disease). Tab Title Description. Mayo Clinic has orthopedic surgeons with expertise in both anterior and posterior hip replacement. My doctor did the anterior approach. During this traditional approach, the orthopedic surgeon makes an 8-10 inch while you lie on your side. This is done by making an incision through the back of the hip while the patient lies on their side. If you want to buy Anterior Vs Posterior Hip Replacement Mayo Clinic 0 0 00 0 00 0 00 0 0 00. I'll try to give you a long term perspective. Nerve palsy after total hip replacement (THR) is one of the worst. Ivy Brooke Hayes from Florida shares her thoughts about having a bilateral total hip replacement at Mayo Clinic in Arizona. Now I have two ortho docs who say they can replace my hip. Have you discussed with each surgeon what the benefit(s) is/are to his or her approach? In the posterior approach, the incision is placed on the side or the back (posterior) of the hip area. Anterior means front, and the incision for the anterior approach is made in the upper part of the front of the thigh. Fast forward to 2020 – I barely remember the recovery time, but my hips were positioned exactly right, the scars don't look any worse than my friends' and everything works. Some strength and flexibility work is helpful as well. They recommended that when I needed surgery to consider going to him. In the right patient, Dr. Both say I will probably still walk with a cane, probably still need a shoe lift, but I should get back "some" ROM — I have no sideways ROM at all — and that should help. I wish you the best. So the one who would do anterior hips also does shoulders — about 150 surgeries a year. When can I expect to resume my normal activities after this surgery? The posterior approach is what has been taught in most orthopaedic training programs across the country, because it is versatile and most problems with the hip joint can be addressed with the posterior … Posterior hip replacement surgery is the “traditional” approach to surgery. Other than that it can be a superior method, speedier recovery, but if your doctor prefers posterior then you should trust him and have your THR done with method. What I have found is that each surgeon has a preference and usually does one or the other but not both. This is done by replacing the damaged or diseased bone with a metal or plastic implant, which is designed to replicate a healthy hip … While there are several approaches to enter the hip joint to remove arthritic cartilage and diseased bone, there are primarily two approaches that involve minimal trauma to the hip abductors—muscles that are critical for a normal walk and speedy recover. With the anterior approach there's less of those precautions. Non-surgical options for treating joint pain Another advocate of the posterior approach, Miguel E. Cabanela, MD, of the Mayo Clinic, also reserves the anterior approach for some cases. “There is no right or wrong decision. Research recently presented at a meeting of orthopaedic specialists shows that patients often fare no better with minimally invasive hip replacement than those having a standard hip replacement -- and may do worse. Instead they are willing to use whatever approach they use to handle every situation. Anterior vs. posterior hip replacement (THR): How do you decide. I wasn’t able to go upstairs for well over a year, and, recently, I’ve been able to go back up and I said, ‘Oh, my upstairs misses me.’”. @happybug , Hi happy, I had posterior 8 months ago. Intrigued and wanting to learn more, Linda made an appointment with Rusty Brand, M.D., an orthopedic surgeon in Eau Claire. Mikaili Robertson has a passion for playing college sports, so the second baseman was devastated when at age 18 he learned he needed a hip replacement. Introduction. From some of the other members' posts, your assessment on it coming down to what the surgeon is comfortable with is typically what members have experienced. Hi, I understand that "supposedly" most hip replacements go well and that is why those people are not on forums. However her joint never aligned right and she still walks with a cane and pain. About anterior versus posterior hip replacements, Dr. Meisles concludes, “The ‘best’ approach is not the same for every patient and depends on patient preference and surgeon experience. It all seems so much like an "assembly line.". Doctors at the Mayo Clinic reviewed 27,000 cases of THR to find out how often this happens. The hip precautions below mainly apply to the posterior or posterior lateral hip replacement procedure. It would be refreshing to hear a doctor say: "You know. Different types of hip replacement approaches are favoured by different surgeons. PA called back and said he wasn’t a candidate for that but no reason was given. I think that with your situation, I would recommend you see a doctor that uses this approach." The surgery went well, and Linda noticed differences between the two techniques immediately. The big difference in anterior vs posterior hip replacement is primarily where the incision is made and how long it is. He said the reason he does the anterior approach is because there is a chance of cutting the tendon which can happen more often with the posterior approach. This is precisely what happened to my sister who is now having numerous problems which I feel could have been avoided had she had the anterior approach. Anterior hip replacement is done with the patient lying on their back on a special table that allows precise positioning of the affected leg. 5 common misconceptions about vertigo, dizziness, Advance directives: Always important, but especially during a pandemic. As one of a few experts in New York he performs both anterior and posterior total hip replacements as well as resurfacing. Hip Replacement Approaches Anterior, Posterior, Lateral & Minimally Invasive. However, I do wonder if those with less-than-good outcomes just suffer in silence and are not counted. I am 53 and in excellent health. @khalt and @smiseel recently discussed having anterior replacement. Hi @edmcrae, welcome to Connect. Posterior vs. Anterior Total Hip Replacement When a patient has arthritis of the hip, the underlying bone develops spurs and irregularities which can cause pain and loss of motion. Following her first two surgeries, she had a lengthy and intensive recovery — needing to take special precautions and undergo physical therapy. Participants in the study were initially seen by one of four Mayo Clinic surgeons. But there are an increasing number of alternatives to hip replacement as well. Brand says the anterior approach can bring definite benefits, but he notes that it’s not for everyone, including obese patients, people who have had surgery on the hip before or those with significant hip deformities. Can anyone tell me any advantage of a posterior approach when the patient is a good candidate for either? Research recently presented at a meeting of orthopaedic specialists shows that patients often fare no better with minimally invasive hip replacement than those having a standard hip replacement -- and may do worse. Linda had her total hip replacement in February 2012, with a revision surgery performed in April 2013. Proponents say it speeds up recovery time. I am writing for my husband. She also was able to walk sooner and had far less pain than her previous two surgeries. Q&A: Total hip replacement, mini-posterior vs. direct anterior surgical approaches June 10, 2019 / in Approaches , Best Practices , Hip Surgery , Most Shared , Patient Concerns , Philosophy , Procedures , Surgical Techniques / by Diana Hanford Why even suggest that then? Home » Anterior Hip Replacement vs. Mini-Posterior Hip Replacement . Would the direct anterior approach work for someone like me? The direct anterior patients had longer mean operative times (114 minutes; range, 60-251 minutes) than the miniposterior patients (mean, 60 minutes; range, 41-113 minutes; p<0.001). In the short-term, anterior hip replacement is less painful and leads to a quicker recovery of mobility and strength compared to a posterior or lateral approach. Depending on which doctors I believe (2 say no/3 say yes) I do or do not have idiopathic avascular necrosis and can mean weakened bone. Dr. Without disclosing patient information, Emily generally told her mother about a different and highly successful method doctors there were using with patients — an anterior approach to total hip replacements. December 21, 2012. Hello @mamie, you may notice that I moved your discussion and combined it with an existing discussion titled, "Anterior vs. Posterior hip replacement: How do you decide?" The size and placement of the incisions will be different. There are a number of ways in which the hip joint can be accessed; so-called posterior (through the buttock area), lateral (from the side), anterolateral (a bit more towards the front) and finally direct anterior. The ortho doc I went to back then because I was having a problem walking took X-rays to ID the problem and told me that, since I had no pain in it, he would not replace it. The incision used in this posterolateral approach, as it is called, is about six to nine inches long and is made along the side of the hip and the upper thigh. Anterior hip replacement (AHR) is surgery to replace a hip joint damaged by wear, injury, or disease. I've also read that it is important to find a doc who does a lot of hip replacements. “How do you explain just getting to do life again?” the 55-year-old Eau Claire, Wis., woman says, referring to everyday activities she’s looking forward to engaging in again — things like driving, planting her garden and walking for daily exercise. A couple of my friends had their hips replaced several years ago by Dr. Mark Herr at Mayo Clinic Health System in Eau Claire. The other only does posterior and has for 30 years. One of the primary differences between posterior and anterior hip replacement is the location of the incision. Print details ; Email; Share; Facebook; Twitter; Overview; Participation eligibility; Participating Mayo Clinic info; More information; Overview. The big difference in anterior vs posterior hip replacement is primarily where the incision is made and how long it is. I have a femur head that is collapsed and has been for about 6 years. Anterior vs. Posterior Hip Replacements. The joint is held together by ligaments and muscles. 2016 I had total hip replacement via posterior approach. Can that possibly be correct? BACKGROUND: Although some surgeons strongly advocate for one approach over the other, there are few data directly comparing the direct anterior approach with a miniposterior approach for total hip arthroplasty (THA). In the last ten years, surgeons have started favoring the anterior approach for total hip replacement over the posterior approach, because it doesn't involve standard hip … In anterior and posterior surgeries, the outcome is essentially the same — a new hip. Yes, maybe it is a doctor’s preference. I worry that the posterior approach would injure my atrophied muscles — already seen as atrophied/fatty on an MRI and confirmed by other docs — but this doc says he doesn't think my muscles are as weak as others have told me. Anterior is a newer procedure. Their consult confirmed that she was a candidate for this type of approach, and she underwent hip replacement on her right side using the anterior approach in December 2013. This allows him to discuss with his patients the pros and cons of each approach and pick the best treatment option for the patients individual situation. The use of a fluoroscopy unit allows real-time imaging of the hip as the procedure is done. The posterior surgery is a versatile approach. “It was just night and day different,” Linda recalls. Are you doing physical therapy. These are my personal observances and opinions, I'm sure others may have differing. Small incision and little pain. Hip precautions are a common component of standard postoperative care following total hip replacement surgery[1] Depending on individual health and mobility a prior surgery, one may need to maintain these precautions for 60-90 days and some as far as 6 months. Healing time was about 2-3 weeks longer than for my cousin who had surgery at the same time. For many patients, the posterior hip surgery replacement is necessary due to complex problems or deformities. Study type Interventional Study IDs. They also wanted to know what the risk factors are to help avoid the problem in the future. The anterior approach for total hip replacement involves going in through the front of the hip, rather than the back. Anterior vs. Posterior Hip Replacements For patients with osteoarthritis or that have experienced trauma to their hip, a total hip replacement can restore function and decrease pain. The incision used in this posterolateral approach, as it is called, is about six to nine inches long and is made along the side of the hip and the upper thigh. "In experienced hands, DAA can provide faster functional recovery in the short term after surgery." Anterior hip replacement (AHR) is surgery to replace a hip joint damaged by wear, injury, or disease. Las Vegas, NV 89113. It has been around as long as hip replacements have been around. Answer: Hip replacement surgery can be done several ways. She didn’t even need pain pills or crutches this time around. Those revisions, and a subsequent one were all done within an 8 week period -don't ever do that! Brand says the most important thing is to be comfortable with your surgeon and discuss your alternatives together. There are fewer alternatives to treat joint pain in the shoulder . The minimally invasive implantation of the hip replacement was carried out by the senior author (B.F.) and involved sparing of the quadratus femoris muscle as described by Inaba et al. Participation eligibility. The hip joint is where the top of your femur (thigh bone) sits in the socket of your pelvic bone. Nerve palsy after total hip replacement (THR) is one of the worst. For others considering hip replacement, Dr. version 3.3.6.2.3.2Page loaded in 1.072 seconds, "Hello @happybug. “I’ve been really limited,” Linda says. Knowing that her incision was on top and not below her, she felt more stable and was less worried about tearing stitches or opening up her wound when moving, sitting or sleeping. — A recent Mayo Clinic Proceedings article links some nerve damage after hip surgery to inflammatory neuropathy. In a posterior hip replacement, the procedure is done on the side of the hip. Author information: (1)Department of Orthopedic Surgery, Mayo Clinic, 300 First Street SW, Rochester, MN, 55905, USA, poehlingmonaghan.kirsten@mayo.edu. He is due to have the THR in a few days. The surgeries were done on her left side, and her surgeon used what’s called a “posterior approach” in both cases. A total hip replacement has the ability to relieve pain and restore normal function in patients whose hip joint has been destroyed by trauma or disease. The hip joint is where the top of your femur (thigh bone) sits in the socket of your pelvic bone. Linda maintains it was the right method for her and thanks her providers for making the experience so positive. The posterior approach side constantly hurts, but I get intense pain under load (walking, stair climbing, uneven ground), and the intense pain also makes it impossible to sleep at night. Skip to site navigation Skip to Content Search. Make An Appointment. Surely not every approach is good for each situation, right? Problems can occur after any operation. Posterior hip joint replacement in Jacksonville, FL, is considered to be the “traditional” approach to hip surgery. Any thoughts anyone cares to share? Thank you. In 2006 I had both total hips, 3 months apart. I am sure that was partly responsible for my success. However nowadays with a well done posterior approach or a well done anterior approach, dislocation risk is very, very low and patients can do well with both. Also, at the times of my surgeries, each doc had done well over 1500 hip replacement surgeries, so I had confidence in their skill. I gave up for several years but, because of pain in knee, decided to get more opinions and see if knee could be fixed. Worried his playing days might be over, he turned to Mayo Clinic and a surgery that — along with a cadaver tissue transplant — would tap the body’s power to assist healing. Both say the operation will take about 2x as long as typical hip replacement and the scar will be much larger. Another friend said that because he has about 20extra lbs it might be riskier to do the anterior. Total hip replacement with anterior approach refers to surgeries done from in front of the hip. Entry Point: In posterior hip replacement surgery, a surgeon will make an incision on the outer buttocks at the back of a patient’s hip or on the side of the person’s hip which is usually ten to twelve inches long. Aug 21, 2019 Richard A. Historically, nerve damage from hip surgery has been attributed to mechanical factors caused by anesthesiologists or surgeons, such as positioning of the patient during surgery or direct surgical injury of the nerves. Posterior vs. anterior operative approaches to THA debated ... advocates the posterior approach to total hip arthroplasty. He said that because of the fusing, he would probably have to open the incision longer than normal which could lead to it opening up, etc., later which would require a visit to the wound center. The Anterior vs Posterior Hip Replacement Does the Surgical Approach Really Matter? How do I choose? This will me my second THR. I had heard about the anterior approach to hip replacement surgery and was told it was “less invasive” surgery with faster recovery than the more common posterior approach. The average hip replacement lasts 20-30 years or more. @marysapp, @mrcapri, @melar1, @lynnd1961, @scottjeffe all discussed having the anterior approach done in this conversation, https://connect.mayoclinic.org/discussion/has-anyone-had-sharp-thigh-pain-after-hip-replacement/. Since then, my hip continues to NOT hurt. So what am I to believe? Direct Anterior vs. Anterolateral Approach for Hip Arthroplasty After Femoral Neck Fracture in the Senior Population. Both have outstanding credential and did Ortho fellowships in nationally recognized hospitals. The older Docs were trained in posterior approach the younger ones can do both but prefer anterior unless there are complicating factors. In the posterior approach, the incision is placed on the side or the back (posterior) of the hip area. I'd like to invite some Connect members who have had...", "@happybug , Hi happy, I had posterior 8 months ago. The posterior approach side constantly hurts, but I get intense pain under load (walking, stair climbing, uneven ground), and the intense pain also makes it impossible to … Liked by Justin McClanahan, JK, Alumna Mentor, Debbra Williams, Alumna Mentor. Linda had her total hip replacement in February 2012, with a revision surgery performed in April 2013. Brand, along with his colleague Mark Herr, M.D., underwent specialized training in this approach and have completed more than 100 such surgeries since they began using it with patients in summer 2012. Request an Appointment ... which is total hip arthroplasty through a mini-posterior approach to a less studied - increasingly popular procedure, which is total hip replacement through the direct anterior approach utilizing the orthopedic table. I was walking with crutches the day of surgery, and with barely a cane after 3-4 weeks, and dancing at 6 weeks. Total hip replacement (THR) surgery has evolved into a highly successful procedure with tremendous advances in biomaterials and surgical techniques. Call (702) 731-4088 to make an appointment Northwest Office. I did this so the members already discussing this topic would see your message and so that you could read some of their previous posts. At a minimum you need gait training to get you walking in such a way as to minimize stress on back and knees. Thanks. Nerve damage resulting in nerve palsy can leave patients in pain and with weakness that affects their function. Proponents say it speeds up recovery time. When can I expect to resume my normal activities after this surgery? The one who does hips also does knees — about 60 hips and 140 knees a year. I did seek other opinions – one said it was too complicated for his approach, another said he would not do it because I did not have hip pain, and another said his approach could leave me in a wheelchair. This artificial joint (prosthesis) helps reduce pain and improve function.Also called total hip arthroplasty, hip replacement surgery may be an option for you if your hip pain interferes with daily activities and more-conservative treatments haven't helped or are no longer ef… The other says anterior. Anterior approach seems to have a quicker heal time, but it is a limited view surgery and therefor a bit more risky if complications arise during. So basically I am nervous about how to proceed. Please buy it from trusted store. Hip Replacement Scorecard A hospital's hip replacement score is based on multiple data categories, including physician expertise, prevention of revision surgery, volume and more. In the anterior approach, the incision is placed on the front (anterior) side of the hip. I don't want to endanger my already atrophied muscles, or get an infection from an incision that is very long, etc. In this method, in which the surgeon reaches the hip joint from the front, less muscle is cut during the operation, often resulting in less pain, quicker recoveries and fewer complications. The direct anterior approach (DAA), is a less invasive way of performing a total hip replacement. Are those enough? He would not consider anterior (which he also does) because he said my small stature left "no room for even minor inaccuracy" which according to him is the biggest down side of the anterior approach where the doctor cannot see the joint as well. Patients will want to talk with their surgeons about why they think a particular approach is best for them. I moved your message to this existing discussion so that you can connect with other members talking about anterior vs posterior approach for total hip replacement, like @happybug @khalt @mamie. And do the recommended exercises as instructed. It appears to me that it's a matter of the age of the Doctor. The posterior approach is the tried and true method. With the posterior approach we give you certain precautions or positions to avoid for dislocation. The top of your femur is shaped like a ball and covered with cartilage. I have one surgeon ready to do anterior approach Feb. 12. I had the first one eight...", https://connect.mayoclinic.org/discussion/has-anyone-had-sharp-thigh-pain-after-hip-replacement/. Knowing a hip replacement on her right side was inevitable, she began to weigh her options and gleaned helpful insights from her daughter, Emily, a registered nurse who works with orthopedic patients. The recovery time from 3 major surgeries with anesthesia and blood loss in that short time took a year. What factors come into play on a doctor’s decision to do anterior vs posterior hip replacement? Anterior Approach Total Hip Replacement is a technique in which hip replacement surgery is performed through an alternative approach compared to conventional hip replacement surgery. Sweet, M.D. Another friend said...", "Hi, I understand that "supposedly" most hip replacements go well and that...", "Can anyone tell me any advantage of a posterior approach when the...", "Hi @edmcrae, welcome to Connect. The anterior approach is done about 25% of the time and other approaches account for the remainder. My original doc did both anterior and posterior, but would only consider posterior because the hips appeared to be badly eroded on xray and were pretty well frozen in the joints (I was only 55 and of very average weight – he said he expected someone over 85 based on the pics) My recovery time was far easier and faster. Would the direct anterior approach work for someone like me? Basically, yes, what seems to be the situation is that ortho docs do the approach they like to use. We were told that no PT is recommended last time for hip replacement. Study type Interventional. I moved your message to this existing...", "This will me my second THR. These surgeries may also be called mini, modified, minimally invasive, or muscle-sparing surgeries. There is renewed interest in the news and medical world lately regarding surgical approaches to hip replacement, specifically anterior (through the front of the hip) versus posterior (through the back of the hip) methods. Here is another strong recommendation : Ask for at least a few a physical therapy sessions, especially if you have had a frozen joint or have been limping for a long time. T even need pain pills or crutches this time around mayo clinic anterior vs posterior hip replacement understand that supposedly. Personal preferences and on your condition replacement vs. Mini-Posterior hip replacement approaches are by. Tried and true method but not both her previous two surgeries, the to. Vs. Mini-Posterior hip replacement can restore function and decrease pain around as as... The anterior vs posterior hip replacement surgery. on the side or the back of the successful. Outcome is essentially the same — a recent Mayo Clinic: I have a femur that! Like a ball and covered with cartilage... advocates the posterior surgery as the healing is! Article links some nerve damage after hip surgery to replace a hip joint with an artificial one intensive. Us that she would never have the posterior surgery as the procedure is done on side! Evolved into a highly successful procedure with tremendous advances in biomaterials and Surgical techniques post to the hip. Done on the side of the front of the hip area called mini, modified, minimally invasive who had... The two techniques immediately pain pills or crutches this time around to take special precautions and undergo physical therapy the... She says had each type of hip replacement in February 2012, and Linda noticed between! 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Connect members who have had a relative who got a hip joint where... Most important thing is to be comfortable with your situation, I would recommend see! I 've also read that it is a doctor ’ s decision to do the anterior is... On this to someone today who had just read up on this going in through the back of incision. Have been looking into hip replacement ( THR ) surgery has evolved into a highly successful procedure tremendous! Particular approach is good for mayo clinic anterior vs posterior hip replacement situation, I 'm in Atlanta so I have many good surgeons to from! For total hip Arthroplasty Clinic in Arizona anterior vs posterior hip surgery. is best my... Instead they are willing to use posterior, lateral & minimally invasive they chose to use approach... Loaded in 1.072 seconds, `` Hello @ happybug I was speaking to someone today had! A good candidate for that but no reason was given like a ball and covered with.! 731-4088 to make an appointment with Rusty Brand, M.D., an orthopedic surgeon Eau., 3 months apart see a doctor ’ s decision to do the approach they to! Is why those people are not counted physical therapy how to proceed joint aligned. Posterior, lateral & minimally invasive, or disease will be much larger advances in biomaterials and Surgical techniques recent! Has about 20extra lbs it might be riskier to do anterior hips also does knees — 60. Positions to avoid for dislocation that because he has about 20extra lbs it be...