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. @happybug , Hi happy, I had posterior 8 months ago. I'll try to give you a long term perspective. Anterior hip replacement (AHR) is surgery to replace a hip joint damaged by wear, injury, or disease. 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… Thanks. Cartilage is a tissue that helps joints move. Anterior is a newer procedure. anterior hip replacement, as well as traditional posterior total hip surgery; knee replacement surgery; trauma-fracture care and surgery; With anterior hip replacement surgery, the surgeon operates on the hip from the front instead of the side or rear of the joint. 2800 East Desert Inn, Suite 100. Posterior vs. anterior operative approaches to THA debated ... advocates the posterior approach to total hip arthroplasty. Liked by Justin McClanahan, JK, Alumna Mentor, Debbra Williams, Alumna Mentor. I'd like to invite some Connect members who have had each type of hip replacement. Answer: Hip replacement surgery can be done several ways. I've also read that it is important to find a doc who does a lot of hip replacements. The last was in 2012, and I am doing fine, active and the only pain is from arthritis and a little bursitis. The top of your femur is shaped like a ball and covered with cartilage. 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. She didn’t even need pain pills or crutches this time around. The other says anterior. 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?" “I think it does have some advantages, but it’s just one of many surgical approaches that work for hip replacement,” he says. The anterior approach for total hip replacement involves going in through the front of the hip, rather than the back. The older Docs were trained in posterior approach the younger ones can do both but prefer anterior unless there are complicating factors. 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. The size and placement of the incisions will be different. In a posterior hip replacement, the procedure is done on the side of the hip. The surgeries were done on her left side, and her surgeon used what’s called a “posterior approach” in both cases. So the one who would do anterior hips also does shoulders — about 150 surgeries a year. I'd like to invite some Connect members who have had...", "@happybug , Hi happy, I had posterior 8 months ago. I think that with your situation, I would recommend you see a doctor that uses this approach." Total hip replacement (THR) surgery has evolved into a highly successful procedure with tremendous advances in biomaterials and surgical techniques. Nerve palsy after total hip replacement (THR) is one of the worst. Linda maintains it was the right method for her and thanks her providers for making the experience so positive. Linda had her total hip replacement in February 2012, with a revision surgery performed in April 2013. When can I expect to resume my normal activities after this surgery? 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. It would be refreshing to hear a doctor say: "You know. 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. 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. This technique involves cutting through muscle in the back of the hip to access the hip joint. The posterior surgery is a versatile approach. Anterior vs. Posterior Hip Replacements. The recovery time from 3 major surgeries with anesthesia and blood loss in that short time took a year. Her husband opted for posterior. My recovery time was far easier and faster. The other only does posterior and has for 30 years. 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. He was walking with a cain the next day. Instead they are willing to use whatever approach they use to handle every situation. 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?" Kate S. Hamilton, PA-C. Introduction. Study type Interventional. I am writing for my husband. My doctor did the anterior approach. 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. She also was able to walk sooner and had far less pain than her previous two surgeries. Anterior means front, and the incision for the anterior approach is made in the upper part of the front of the thigh. Cartilage is a tissue that helps joints move. — A recent Mayo Clinic Proceedings article links some nerve damage after hip surgery to inflammatory neuropathy. Hip Replacement Approaches Anterior, Posterior, Lateral & Minimally Invasive. Basically, yes, what seems to be the situation is that ortho docs do the approach they like to use. 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. 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. 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. Can anyone tell me any advantage of a posterior approach when the patient is a good candidate for either? One randomized clinical trial of direct anterior THA versus contemporary miniposterior approach THA suggested an early functional advantage for the direct anterior group, but importantly, there were different postoperative instructions given to those two groups of patients, with the miniposterior group alone being cautioned to follow traditional hip dislocation precautions . @khalt @happybug I was speaking to someone today who had just read up on this! 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. Anterior hip replacement (AHR) is surgery to replace a hip joint damaged by wear, injury, or disease. Total hip replacement with anterior approach refers to surgeries done from in front of the hip. 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 … If you have had a relative who got a hip replacement several years ago, chances are it was a posterior surgery. They also wanted to know what the risk factors are to help avoid the problem in the future. @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/. Before You Buy, You Should to: Reading the consumer testimonials of Anterior Vs Posterior Hip Replacement Mayo Clinic 0 0 00 0 00 0 00 0 0 00 before get. Doctors at the Mayo Clinic reviewed 27,000 cases of THR to find out how often this happens. version 3.3.6.2.3.2Page loaded in 1.072 seconds, "Hello @happybug. Hello @happybug. The big difference in anterior vs posterior hip replacement is primarily where the incision is made and how long it is. Metal alloys now used are much more durable. The direct anterior approach (DAA), is a less invasive way of performing a total hip replacement. 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. Why even suggest that then? 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. 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. 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. 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. It appears to me that it's a matter of the age of the Doctor. Please buy it from trusted store. Historically, hip replacement surgery was performed utilizing traditional posterior or lateral approaches. Yes, maybe it is a doctor’s preference. 2016 I had total hip replacement via posterior approach. During hip replacement, a surgeon removes the damaged sections of your hip joint and replaces them with parts usually constructed of metal, ceramic and very hard plastic. 702-731-4088 . It is fusing onto the socket that it should be rotating in. I am 53 and in excellent health. Call (702) 731-4088 to make an appointment Northwest Office. Since then, my hip continues to NOT hurt. 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. We were told that no PT is recommended last time for hip replacement. I wish you the best. 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. Are you doing physical therapy. Ed, were you a candidate for either 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. Hi, @JustinMcClanahan Thanks for moving my post to the proper category. The top of your femur is shaped like a ball and covered with cartilage. Those revisions, and a subsequent one were all done within an 8 week period -don't ever do that! The average hip replacement lasts 20-30 years or more. JK. 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. 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. Different types of hip replacement approaches are favoured by different surgeons. Surely not every approach is good for each situation, right? Participants in the study were initially seen by one of four Mayo Clinic surgeons. This technique allows patients to recover and return to activities and work quickly. Would the direct anterior approach work for someone like me? Will be having a pre-op dr appt in a few days. @khalt and @smiseel recently discussed having anterior replacement. For others considering hip replacement, Dr. Now I have two ortho docs who say they can replace my hip. 5 common misconceptions about vertigo, dizziness, Advance directives: Always important, but especially during a pandemic. There are fewer alternatives to treat joint pain in the shoulder . Proponents say it speeds up recovery time. The one who would use the anterior approach also does do posterior and has for about 14 years. Patients will want to talk with their surgeons about why they think a particular approach is best for them. That should give you an idea of the recovery time involved. Salyapongse explains what he has seen first hand: "patients who have had anterior hip surgery on one side and posterior hip surgery on the other, most often prefer the anterior hip side." Brand says the most important thing is to be comfortable with your surgeon and discuss your alternatives together. I have one surgeon ready to do anterior approach Feb. 12. This allows precise placement of components that are correctly sized. @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? Thank you. Anterior hip replacement is done with the patient lying on their back on a special table that allows precise positioning of the affected leg. 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. How do I choose? Doctors at the Mayo Clinic reviewed 27,000 cases of THR to find out how often this happens. In anterior and posterior surgeries, the outcome is essentially the same — a new hip. A relative my age and size talked her doc into an anterior incision at that time, her initial recovery was about a month shorter than mine. I moved your message to this existing...", "This will me my second THR. “It was just night and day different,” Linda recalls. However her joint never aligned right and she still walks with a cane and pain. 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 … Dear Mayo Clinic: I have severe arthritis in my hip and have been looking into hip replacement surgery. Another friend said that because he has about 20extra lbs it might be riskier to do the anterior. Anterior vs. posterior hip replacement (THR): How do you decide. One of the primary differences between posterior and anterior hip replacement is the location of the incision. These are my personal observances and opinions, I'm sure others may have differing. The hip precautions below mainly apply to the posterior or posterior lateral hip replacement procedure. 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. 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. This is not necessarily a bad thing, you want your surgeon confident in their method. Linda had her total hip replacement in February 2012, with a revision surgery performed in April 2013. Another surgeon ready to do posterior. PA called back and said he wasn’t a candidate for that but no reason was given. I had the first one eight years ago. The joint is held together by ligaments and muscles. For many patients, the posterior hip surgery replacement is necessary due to complex problems or deformities. And do the recommended exercises as instructed. With anterior hip replacement surgery, an incision is made on the front of a person’s hip and is four to five inches long. “I haven’t even been able to walk to the mailbox because my hips hurt so much. My husband called the dr’s office to see if he could request the anterior. Mayo Clinic has orthopedic surgeons with expertise in both anterior and posterior hip replacement. Would the direct anterior approach work for someone like me? My buddy same age as me had the anterior approach. “Everything was just superior,” she says. For reasons I don't need to address, I have had 2 total hip replacements and 3 revisions, over a period of 6 years. With the posterior approach we give you certain precautions or positions to avoid for dislocation. If you found fraudulent charges. In the posterior approach, the incision is placed on the side or the back (posterior) of the hip area. 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. Author information: (1)Department of Orthopedic Surgery, Mayo Clinic, 300 First Street SW, Rochester, MN, 55905, USA, poehlingmonaghan.kirsten@mayo.edu. 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 joint is held together by ligaments and muscles. I was walking with crutches the day of surgery, and with barely a cane after 3-4 weeks, and dancing at 6 weeks. A total hip replacement is a type of surgery. 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. If you want to buy Anterior Vs Posterior Hip Replacement Mayo Clinic 0 0 00 0 00 0 00 0 0 00. 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. A couple of my friends had their hips replaced several years ago by Dr. Mark Herr at Mayo Clinic Health System in Eau Claire. These surgeries may also be called mini, modified, minimally invasive, or muscle-sparing surgeries. In posterior hip replacement, the surgeon gains access to the hip with an incision by the buttocks. During this traditional approach, the orthopedic surgeon makes an 8-10 inch while you lie on your side. Also, at the times of my surgeries, each doc had done well over 1500 hip replacement surgeries, so I had confidence in their skill. With the anterior approach there's less of those precautions. Plus I am overweight and that can cause problems with belly fat. Southwest Office. 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. Healing time was about 2-3 weeks longer than for my cousin who had surgery at the same time. In a posterior hip replacement, the procedure is done on the side of the hip. For the report, researchers looked at hospital statistics on total hip replacement -- replacement of the head of the femur (thigh bone) and its socket -- from 2000-2010. Any thoughts anyone cares to share? 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. I have had both hips replaced in the year 2018. 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