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. He is due to have the THR in a few days. I spent a week with a walker. The last was in 2012, and I am doing fine, active and the only pain is from arthritis and a little bursitis. 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. Thanks. Her husband opted for posterior. Aug 21, 2019 Richard A. She didn’t even need pain pills or crutches this time around. Learn more about services at Mayo Clinic. With anterior hip replacement surgery, an incision is made on the front of a person’s hip and is four to five inches long. Will be having a pre-op dr appt in a few days. Plus I am overweight and that can cause problems with belly fat. 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. But there are an increasing number of alternatives to hip replacement as well. Print details ; Email; Share; Facebook; Twitter; Overview; Participation eligibility; Participating Mayo Clinic info; More information; Overview. At 5 years both implants failed and required revision, which the second surgeon did 6 weeks apart, posterior. “I think it does have some advantages, but it’s just one of many surgical approaches that work for hip replacement,” he says. 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. 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 top of your femur is shaped like a ball and covered with cartilage. 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. Proponents say it speeds up recovery time. In the posterior approach, the incision is placed on the side or the back (posterior) of the hip area. For others considering hip replacement, Dr. With the anterior approach there's less of those precautions. Hip replacement surgery is one of the most successful procedures in medicine. The hip precautions below mainly apply to the posterior or posterior lateral hip replacement procedure. 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?" 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 … Would the direct anterior approach work for someone like me? 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. Posterior hip replacement surgery is the “traditional” approach to surgery. The top of your femur is shaped like a ball and covered with cartilage. It is fusing onto the socket that it should be rotating in. This will me my second THR. My concern is that one says, for my situation, it has to be done from the posterior. Posterior vs. anterior operative approaches to THA debated ... advocates the posterior approach to total hip arthroplasty. 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. Kate S. Hamilton, PA-C. Introduction. Ed, were you a candidate for either approach? Anterior means front, and the incision for the anterior approach is made in the upper part of the front of the thigh. Anterior hip replacement is done with the patient lying on their back on a special table that allows precise positioning of the affected leg. 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. 8402 W. Centennial Pkwy. The older Docs were trained in posterior approach the younger ones can do both but prefer anterior unless there are complicating factors. I think that with your situation, I would recommend you see a doctor that uses this approach." In a posterior hip replacement, the procedure is done on the side of the hip. 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 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. In the anterior approach, the incision is placed on the front (anterior) side of the hip. Tab Title Description. So basically I am nervous about how to proceed. Can anyone tell me any advantage of a posterior approach when the patient is a good candidate for either? In the posterior approach, the incision is placed on the side or the back (posterior) of the hip area. Historically, hip replacement surgery was performed utilizing traditional posterior or lateral approaches. Any thoughts anyone cares to share? 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. 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. 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. December 21, 2012. Nerve palsy after total hip replacement (THR) is one of the worst. The size and placement of the incisions will be different. Ivy Brooke Hayes from Florida shares her thoughts about having a bilateral total hip replacement at Mayo Clinic in Arizona. Linda had her total hip replacement in February 2012, with a revision surgery performed in April 2013. Are those enough? They also wanted to know what the risk factors are to help avoid the problem in the future. This is done by making an incision through the back of the hip while the patient lies on their side. Home » Anterior Hip Replacement vs. Mini-Posterior Hip Replacement . There are fewer alternatives to treat joint pain in the shoulder . If you want to buy Anterior Vs Posterior Hip Replacement Mayo Clinic 0 0 00 0 00 0 00 0 0 00. 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 . Liked by Justin McClanahan, JK, Alumna Mentor, Debbra Williams, Alumna Mentor. The one who would use the anterior approach also does do posterior and has for about 14 years. 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. The surgeries were done on her left side, and her surgeon used what’s called a “posterior approach” in both cases. The anterior approach for total hip replacement involves going in through the front of the hip, rather than the back. Linda had her total hip replacement in February 2012, with a revision surgery performed in April 2013. Now I have two ortho docs who say they can replace my hip. 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 … 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’ve been really limited,” Linda says. I am 53 and in excellent health. That should give you an idea of the recovery time involved. Both say the operation will take about 2x as long as typical hip replacement and the scar will be much larger. Proponents say it speeds up recovery time. Anterior vs. Posterior Hip Replacements. What I have found is that each surgeon has a preference and usually does one or the other but not both. As one of a few experts in New York he performs both anterior and posterior total hip replacements as well as resurfacing. What I...", "Thank you. Anterior hip replacement (AHR) is surgery to replace a hip joint damaged by wear, injury, or disease. 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. Before Hip Replacement, Consider All Options for Treating Hip Arthritis. 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. If you found fraudulent charges. In anterior and posterior surgeries, the outcome is essentially the same — a new hip. Make An Appointment. Yes, maybe it is a doctor’s preference. This is not necessarily a bad thing, you want your surgeon confident in their method. 2016 I had total hip replacement via posterior approach. 8205 W. Warm Springs Road, Suite 250 . 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'd like to invite some Connect members who have had...", "@happybug , Hi happy, I had posterior 8 months ago. 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. The surgery went well, and Linda noticed differences between the two techniques immediately. 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) JK. He had one THR a few years ago – posterior. 2800 East Desert Inn, Suite 100. This technique involves cutting through muscle in the back of the hip to access the hip joint. However, I do wonder if those with less-than-good outcomes just suffer in silence and are not counted. Anterior means front, and the incision for the anterior approach is made in the upper part of the front of the thigh. What factors come into play on a doctor’s decision to do anterior vs posterior hip replacement? 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). Thank you. The posterior approach is the tried and true method. Direct Anterior vs. Anterolateral Approach for Hip Arthroplasty After Femoral Neck Fracture in the Senior Population. Skip to site navigation Skip to Content Search. I am writing for my husband. Total hip replacement (THR) surgery has evolved into a highly successful procedure with tremendous advances in biomaterials and surgical techniques. The other only does posterior and has for 30 years. Basically, yes, what seems to be the situation is that ortho docs do the approach they like to use. When can I expect to resume my normal activities after this surgery? It has been around as long as hip replacements have been around. 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. 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. 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 … 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. 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). The big difference in anterior vs posterior hip replacement is primarily where the incision is made and how long it is. This is done by replacing the damaged or diseased bone with a metal or plastic implant, which is designed to replicate a healthy hip … Why even suggest that then? 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. If you have had a relative who got a hip replacement several years ago, chances are it was a posterior surgery. The recovery time from 3 major surgeries with anesthesia and blood loss in that short time took a year. Cartilage is a tissue that helps joints move. My doctor did the anterior approach. For reasons I don't need to address, I have had 2 total hip replacements and 3 revisions, over a period of 6 years. Non-surgical options for treating joint pain So what am I to believe? 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. It appears to me that it's a matter of the age of the Doctor. My glute muscles also have atrophied. @happybug , Hi happy, I had posterior 8 months ago. It would be refreshing to hear a doctor say: "You know. For many patients, the posterior hip surgery replacement is necessary due to complex problems or deformities. 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. In posterior hip replacement, the surgeon gains access to the hip with an incision by the buttocks. Anterior is a newer procedure. Study type Interventional. Ivy Brooke Hayes from Florida shares her thoughts about having a bilateral total hip replacement at Mayo Clinic in Arizona. 702-731-4088 . 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. 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. It replaces your hip joint with an artificial one. Hello @happybug. @khalt @happybug I was speaking to someone today who had just read up on this! "In experienced hands, DAA can provide faster functional recovery in the short term after surgery." The direct anterior group had a higher maximum visual analog scale pain score (5.3 direct anterior; ±2, … Can that possibly be correct? She also was able to walk sooner and had far less pain than her previous two surgeries. Doctors at the Mayo Clinic reviewed 27,000 cases of THR to find out how often this happens. Las Vegas, Nevada 89149. Both have outstanding credential and did Ortho fellowships in nationally recognized hospitals. One of the primary differences between posterior and anterior hip replacement is the location of the incision. I had the first one eight...", https://connect.mayoclinic.org/discussion/has-anyone-had-sharp-thigh-pain-after-hip-replacement/. Brand says the most important thing is to be comfortable with your surgeon and discuss your alternatives together. 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… Plus neither have mentioned — other than saying I would need a shoe lift, which I already use now — if they would have to cut off any more bone before inserting the femoral stem — making my leg even shorter. I was walking with crutches the day of surgery, and with barely a cane after 3-4 weeks, and dancing at 6 weeks. Answer: Hip replacement surgery can be done several ways. 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. Yes, maybe it is a doctor’s preference. I don't want to endanger my already atrophied muscles, or get an infection from an incision that is very long, etc. The one who does hips also does knees — about 60 hips and 140 knees a year. The direct anterior approach (DAA), is a less invasive way of performing a total hip replacement. Posterior hip joint replacement in Jacksonville, FL, is considered to be the “traditional” approach to hip surgery. 5 common misconceptions about vertigo, dizziness, Advance directives: Always important, but especially during a pandemic. The anterior approach is done about 25% of the time and other approaches account for the remainder. 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. Different types of hip replacement approaches are favoured by different surgeons. 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 … 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. My buddy same age as me had the anterior approach. The use of a fluoroscopy unit allows real-time imaging of the hip as the procedure is done. 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 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. “It was just night and day different,” Linda recalls. Aims: We wished to quantify the extent of soft-tissue damage sustained during minimally invasive total hip arthroplasty through the direct anterior (DA) and direct superior (DS) approaches. Metal alloys now used are much more durable. 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 have one surgeon ready to do anterior approach Feb. 12. Those revisions, and a subsequent one were all done within an 8 week period -don't ever do that! 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 — A recent Mayo Clinic Proceedings article links some nerve damage after hip surgery to inflammatory neuropathy. 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.’”. I know each doc has his/her preferences, but I would like to know what is best for MY situation. So the one who would do anterior hips also does shoulders — about 150 surgeries a year. I had the posterior approach with all of those muscles cut, woke up with 28 staples, two drains and a lot of pain. Total hip replacement with anterior approach refers to surgeries done from in front 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. However, because it is locked in place, my back and my knee must do the movement and pain has developed in those two parts. 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. It allows the surgeon to fully visualize the hip and perform any type of reconstruction necessary during the procedure. When can I expect to resume my normal activities after this surgery? 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. Another surgeon ready to do posterior. Simply click VIEW & REPLY to read past posts. Watch Derick Johnson, DO, The Bone & Joint Center in Holland, Michigan and anterior approach hip replacement surgery. Dear Mayo Clinic: I have severe arthritis in my hip and have been looking into hip replacement surgery. Problems can occur after any operation. The anterior approach for total hip replacement involves going in through the front of the hip, rather than the back. Hi @edmcrae, welcome to Connect. This technique involves cutting through muscle in the back of the hip to access the hip joint. 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.