He is due to have the THR in a few days. Print details ; Email; Share; Facebook; Twitter; Overview; Participation eligibility; Participating Mayo Clinic info; More information; Overview. This is done by replacing the damaged or diseased bone with a metal or plastic implant, which is designed to replicate a healthy hip … Will be having a pre-op dr appt in a few days. One of the primary differences between posterior and anterior hip replacement is the location of the incision. Posterior hip replacement surgery is the “traditional” approach to surgery. For others considering hip replacement, Dr. The one who does hips also does knees — about 60 hips and 140 knees a year. 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 … However, because it is locked in place, my back and my knee must do the movement and pain has developed in those two parts. I had the first one eight years ago. This allows precise placement of components that are correctly sized. Can anyone tell me any advantage of a posterior approach when the patient is a good candidate for either? 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. Surely not every approach is good for each situation, right? 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. Posterior hip joint replacement in Jacksonville, FL, is considered to be the “traditional” approach to hip surgery. Hi @edmcrae, welcome to Connect. Aug 21, 2019 Richard A. The size and placement of the incisions will be different. Those revisions, and a subsequent one were all done within an 8 week period -don't ever do that! Intrigued and wanting to learn more, Linda made an appointment with Rusty Brand, M.D., an orthopedic surgeon in Eau Claire. My buddy same age as me had the anterior approach. 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. I know each doc has his/her preferences, but I would like to know what is best for MY situation. At 5 years both implants failed and required revision, which the second surgeon did 6 weeks apart, posterior. If you found fraudulent charges. This technique allows patients to recover and return to activities and work quickly. They also wanted to know what the risk factors are to help avoid the problem in the future. 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. 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.’”. At a minimum you need gait training to get you walking in such a way as to minimize stress on back and knees. In the posterior approach, the incision is placed on the side or the back (posterior) of the hip area. The Anterior vs Posterior Hip Replacement Does the Surgical Approach Really Matter? Learn more about services at Mayo Clinic. However, I do wonder if those with less-than-good outcomes just suffer in silence and are not counted. The posterior approach is the tried and true method. Thank you. Introduction. The other says anterior. Hello @happybug. In a posterior hip replacement, the procedure is done on the side of the hip. Are you doing physical therapy. The average hip replacement lasts 20-30 years or more. @khalt and @smiseel recently discussed having anterior replacement. “I’ve been really limited,” Linda says. The top of your femur is shaped like a ball and covered with cartilage. I'd like to invite some Connect members who have had...", "@happybug , Hi happy, I had posterior 8 months ago. 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 joint is held together by ligaments and muscles. 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. The other only does posterior and has for 30 years. Direct Anterior vs. Anterolateral Approach for Hip Arthroplasty After Femoral Neck Fracture in the Senior Population. 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. The primary aim of the study is to compare the results of an established, successful procedure, 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 have had both hips replaced in the year 2018. @happybug, if you don't mind sharing, are you looking at having a hip replaced and has your surgeon discussed which route they would use? I was walking with crutches the day of surgery, and with barely a cane after 3-4 weeks, and dancing at 6 weeks. 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. Any thoughts anyone cares to share? In anterior and posterior surgeries, the outcome is essentially the same — a new hip. 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. 2017 I had total hip replacement anterior approach. I'd like to invite some Connect members who have had each type of hip replacement. 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. @khalt @happybug I was speaking to someone today who had just read up on this! Since then, my hip continues to NOT hurt. This technique involves cutting through muscle in the back of the hip to access the hip joint. 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?" 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) Anterior is a newer procedure. With the posterior approach we give you certain precautions or positions to avoid for dislocation. Her husband opted for posterior. He was walking with a cain the next day. — A recent Mayo Clinic Proceedings article links some nerve damage after hip surgery to inflammatory neuropathy. 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. Now I have two ortho docs who say they can replace my hip. 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. My glute muscles also have atrophied. 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. For many patients, the posterior hip surgery replacement is necessary due to complex problems or deformities. 702-731-4088 . The big difference in anterior vs posterior hip replacement is primarily where the incision is made and how long it is. Another friend said that because he has about 20extra lbs it might be riskier to do the anterior. 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… “I haven’t even been able to walk to the mailbox because my hips hurt so much. I am 53 and in excellent health. Simply click VIEW & REPLY to read past posts. My husband called the dr’s office to see if he could request the anterior. Why even suggest that then? 8402 W. Centennial Pkwy. The one who would use the anterior approach also does do posterior and has for about 14 years. The direct anterior group had a higher maximum visual analog scale pain score (5.3 direct anterior; ±2, … “Everything was just superior,” she says. Study type Interventional Study IDs. Linda maintains it was the right method for her and thanks her providers for making the experience so positive. They'll tell you that this method or that method is better, but what they really mean is, "I'm comfortable doing this method so that's what i'm going to talk you in to." Liked by Justin McClanahan, JK, Alumna Mentor, Debbra Williams, Alumna Mentor. Healing time was about 2-3 weeks longer than for my cousin who had surgery at the same time. 2016 I had total hip replacement via posterior approach. Before Hip Replacement, Consider All Options for Treating Hip Arthritis. In 2006 I had both total hips, 3 months apart. Participants in the study were initially seen by one of four Mayo Clinic surgeons. They also wanted to know what the risk factors are to help avoid the problem in the future. 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 The recovery time from 3 major surgeries with anesthesia and blood loss in that short time took a year. We were told that no PT is recommended last time for hip replacement. 2017 I had total hip replacement anterior approach. A total hip replacement is a type of surgery. Answer: Hip replacement surgery can be done several ways. In the anterior approach, the incision is placed on the front (anterior) side of the hip. 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. Following her first two surgeries, she had a lengthy and intensive recovery — needing to take special precautions and undergo physical therapy. The hip precautions below mainly apply to the posterior or posterior lateral hip replacement procedure. Anterior hip replacement (AHR) is surgery to replace a hip joint damaged by wear, injury, or disease. Ed, were you a candidate for either approach? And do the recommended exercises as instructed. 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. What I have found is that each surgeon has a preference and usually does one or the other but not both. Metal alloys now used are much more durable. 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). The posterior surgery is a versatile approach. Adult Reconstruction Fellowship. Are those enough? Would the direct anterior approach work for someone like me? 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. Linda had her total hip replacement in February 2012, with a revision surgery performed in April 2013. Dr. 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. 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. Mayo Clinic has orthopedic surgeons with expertise in both anterior and posterior hip replacement. I've also read that it is important to find a doc who does a lot of hip replacements. Hip replacement surgery is one of the most successful procedures in medicine. 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. Dear Mayo Clinic: I have severe arthritis in my hip and have been looking into hip replacement surgery. The top of your femur is shaped like a ball and covered with cartilage. The one they chose to use on you will depend on their training, their experience, their personal preferences and on your condition. Thanks. There are fewer alternatives to treat joint pain in the shoulder . I spent a week with a walker. The use of a fluoroscopy unit allows real-time imaging of the hip as the procedure is done. The last was in 2012, and I am doing fine, active and the only pain is from arthritis and a little bursitis. Ivy Brooke Hayes from Florida shares her thoughts about having a bilateral total hip replacement at Mayo Clinic in Arizona. 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. Cartilage is a tissue that helps joints move. I have a femur head that is collapsed and has been for about 6 years. Both have outstanding credential and did Ortho fellowships in nationally recognized hospitals. I wish you the best. The surgeries were done on her left side, and her surgeon used what’s called a “posterior approach” in both cases. They recommended that when I needed surgery to consider going to him. Both say the operation will take about 2x as long as typical hip replacement and the scar will be much larger. So the one who would do anterior hips also does shoulders — about 150 surgeries a year. The surgery went well, and Linda noticed differences between the two techniques immediately. 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. Las Vegas, NV 89113. Have you discussed with each surgeon what the benefit(s) is/are to his or her approach? For patients with osteoarthritis or that have experienced trauma to their hip, a total hip replacement can restore function and decrease pain. As one of a few experts in New York he performs both anterior and posterior total hip replacements as well as resurfacing. The anterior approach is done about 25% of the time and other approaches account for the remainder. It is fusing onto the socket that it should be rotating in. The older Docs were trained in posterior approach the younger ones can do both but prefer anterior unless there are complicating factors. Cartilage is a tissue that helps joints move. 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. 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). 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. I told my regular doctor (internal medicine) I have a choice and he said why would you want the posterior approach? Anterior hip replacement (AHR) is surgery to replace a hip joint damaged by wear, injury, or disease. What I want is the approach best for me. Kate S. Hamilton, PA-C. Introduction. Doctors at the Mayo Clinic reviewed 27,000 cases of THR to find out how often this happens. 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 … Anterior hip replacement is done with the patient lying on their back on a special table that allows precise positioning of the affected leg. If you have had a relative who got a hip replacement several years ago, chances are it was a posterior surgery. 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 … What I...", "Thank you. With anterior hip replacement surgery, an incision is made on the front of a person’s hip and is four to five inches long. 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