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. 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. Yes, maybe it is a doctor’s preference. I have one surgeon ready to do anterior approach Feb. 12. In 2006 I had both total hips, 3 months apart. Answer: Hip replacement surgery can be done several ways. “It was just night and day different,” Linda recalls. Adult Reconstruction Fellowship. Cartilage is a tissue that helps joints move. @happybug , Hi happy, I had posterior 8 months ago. 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. At a minimum you need gait training to get you walking in such a way as to minimize stress on back and knees. 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). Hip replacement surgery is one of the most successful procedures in medicine. In the anterior approach, the incision is placed on the front (anterior) side of the hip. 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. 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. Yes, maybe it is a doctor’s preference. Posterior hip replacement surgery is the “traditional” approach to surgery. Hi, I understand that "supposedly" most hip replacements go well and that is why those people are not on forums. “I haven’t even been able to walk to the mailbox because my hips hurt so much. Aug 21, 2019 Richard A. Hi @edmcrae, welcome to Connect. Direct Anterior vs. Anterolateral Approach for Hip Arthroplasty After Femoral Neck Fracture in the Senior Population. Dear Mayo Clinic: I have severe arthritis in my hip and have been looking into hip replacement surgery. Introduction. So basically I am nervous about how to proceed. @khalt @happybug I was speaking to someone today who had just read up on this! Now I have two ortho docs who say they can replace my 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. Would the direct anterior approach work for someone like me? Home » Anterior Hip Replacement vs. Mini-Posterior Hip Replacement . When can I expect to resume my normal activities after this surgery? That should give you an idea of the recovery time involved. Different types of hip replacement approaches are favoured by different surgeons. Author information: (1)Department of Orthopedic Surgery, Mayo Clinic, 300 First Street SW, Rochester, MN, 55905, USA, poehlingmonaghan.kirsten@mayo.edu. December 21, 2012. 2800 East Desert Inn, Suite 100. Both say the operation will take about 2x as long as typical hip replacement and the scar will be much larger. 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. 2017 I had total hip replacement anterior approach. Nerve palsy after total hip replacement (THR) is one of the worst. Another friend said that because he has about 20extra lbs it might be riskier to do the anterior. 2016 I had total hip replacement via posterior approach. 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) Thank you. 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. I am 53 and in excellent health. We were told that no PT is recommended last time for hip replacement. Anterior hip replacement (AHR) is surgery to replace a hip joint damaged by wear, injury, or disease. A couple of my friends had their hips replaced several years ago by Dr. Mark Herr at Mayo Clinic Health System in Eau Claire. If you have had a relative who got a hip replacement several years ago, chances are it was a posterior surgery. The direct anterior approach (DAA), is a less invasive way of performing a total hip replacement. 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. I have a femur head that is collapsed and has been for about 6 years. What I...", "Thank you. In anterior and posterior surgeries, the outcome is essentially the same — a new hip. Patients will want to talk with their surgeons about why they think a particular approach is best for them. Print details ; Email; Share; Facebook; Twitter; Overview; Participation eligibility; Participating Mayo Clinic info; More information; Overview. "In experienced hands, DAA can provide faster functional recovery in the short term after surgery." 8205 W. Warm Springs Road, Suite 250 . Both have outstanding credential and did Ortho fellowships in nationally recognized hospitals. Her husband opted for posterior. One of the primary differences between posterior and anterior hip replacement is the location of the incision. Plus I am overweight and that can cause problems with belly fat. He was walking with a cain the next day. However, I do wonder if those with less-than-good outcomes just suffer in silence and are not counted. 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. 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). 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. Problems can occur after any operation. Study type Interventional Study IDs. They also wanted to know what the risk factors are to help avoid the problem in the future. With the anterior approach there's less of those precautions. 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. This allows precise placement of components that are correctly sized. Hello @happybug. In posterior hip replacement, the surgeon gains access to the hip with an incision by the buttocks. Las Vegas, NV 89113. Mayo Clinic has orthopedic surgeons with expertise in both anterior and posterior hip replacement. 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." My recovery time was far easier and faster. 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?" 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. 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. This is done by replacing the damaged or diseased bone with a metal or plastic implant, which is designed to replicate a healthy hip joint. Historically, hip replacement surgery was performed utilizing traditional posterior or lateral approaches. He had one THR a few years ago – posterior. 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 … 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. 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. 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 know each doc has his/her preferences, but I would like to know what is best for MY situation. I'd like to invite some Connect members who have had...", "@happybug , Hi happy, I had posterior 8 months ago. Tab Title Description. … Brand says the most important thing is to be comfortable with your surgeon and discuss your alternatives together. 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. I had the first one eight...", https://connect.mayoclinic.org/discussion/has-anyone-had-sharp-thigh-pain-after-hip-replacement/. They also wanted to know what the risk factors are to help avoid the problem in the future. Las Vegas, Nevada 89149. The other only does posterior and has for 30 years. This is done by making an incision through the back of the hip while the patient lies on their side. How do I choose? Anterior is a newer procedure. If you want to buy Anterior Vs Posterior Hip Replacement Mayo Clinic 0 0 00 0 00 0 00 0 0 00. 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… 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. The one who does hips also does knees — about 60 hips and 140 knees a year. 2016 I had total hip replacement via posterior approach. I believe she said it can be riskier for nerves so if your doctor wants to do it you should make sure the doctor has done at least hundreds of them. The anterior approach for total hip replacement involves going in through the front of the hip, rather than the back. — A recent Mayo Clinic Proceedings article links some nerve damage after hip surgery to inflammatory neuropathy. JK. Linda maintains it was the right method for her and thanks her providers for making the experience so positive. Proponents say it speeds up recovery time. The big difference in anterior vs posterior hip replacement is primarily where the incision is made and how long it is. My glute muscles also have atrophied. The recovery time from 3 major surgeries with anesthesia and blood loss in that short time took a year. The other says anterior. Nerve palsy after total hip replacement (THR) is one of the worst. So what am I to believe? They recommended that when I needed surgery to consider going to him. 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?" 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. Dear Mayo Clinic: I have severe arthritis in my hip and have been looking into hip replacement surgery. Southwest Office. He is due to have the THR in a few days. It all seems so much like an "assembly line.". 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. The big difference in anterior vs posterior hip replacement is primarily where the incision is made and how long it is. My husband called the dr’s office to see if he could request the anterior. 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. The older Docs were trained in posterior approach the younger ones can do both but prefer anterior unless there are complicating factors. Study type Interventional. I was walking with crutches the day of surgery, and with barely a cane after 3-4 weeks, and dancing at 6 weeks. In the posterior approach, the incision is placed on the side or the back (posterior) of the hip area. She also was able to walk sooner and had far less pain than her previous two surgeries. Make An Appointment. Can that possibly be correct? 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 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. Doctors at the Mayo Clinic reviewed 27,000 cases of THR to find out how often this happens. Anterior hip replacement (AHR) is surgery to replace a hip joint damaged by wear, injury, or disease. However her joint never aligned right and she still walks with a cane and pain. 702-731-4088 . Before Hip Replacement, Consider All Options for Treating Hip Arthritis. “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. Participants in the study were initially seen by one of four Mayo Clinic surgeons. 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. Please buy it from trusted store. 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. This technique involves cutting through muscle in the back of the hip to access the hip joint. Any thoughts anyone cares to share? 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. If you found fraudulent charges. I think that with your situation, I would recommend you see a doctor that uses this approach." It replaces your hip joint with an artificial one. With anterior hip replacement surgery, an incision is made on the front of a person’s hip and is four to five inches long. 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 top of your femur is shaped like a ball and covered with cartilage. I had the posterior approach with all of those muscles cut, woke up with 28 staples, two drains and a lot of pain. 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. Following her first two surgeries, she had a lengthy and intensive recovery — needing to take special precautions and undergo physical therapy. 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. Basically, yes, what seems to be the situation is that ortho docs do the approach they like to use. The surgery went well, and Linda noticed differences between the two techniques immediately. My concern is that one says, for my situation, it has to be done from the posterior. 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. 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. Intrigued and wanting to learn more, Linda made an appointment with Rusty Brand, M.D., an orthopedic surgeon in Eau Claire. 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. This is not necessarily a bad thing, you want your surgeon confident in their method. The direct anterior group had a higher maximum visual analog scale pain score (5.3 direct anterior; ±2, … Liked by Justin McClanahan, JK, Alumna Mentor, Debbra Williams, Alumna Mentor. 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. Posterior hip joint replacement in Jacksonville, FL, is considered to be the “traditional” approach to hip surgery. Anterior means front, and the incision for the anterior approach is made in the upper part of the front of the thigh. 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." Would the direct anterior approach work for someone like me? 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 … 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. Will be having a pre-op dr appt in a few days. Why even suggest that then? What factors come into play on a doctor’s decision to do anterior vs posterior hip replacement? 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 … Those revisions, and a subsequent one were all done within an 8 week period -don't ever do that! Ivy Brooke Hayes from Florida shares her thoughts about having a bilateral total hip replacement at Mayo Clinic in Arizona. Anterior vs. Posterior Hip Replacements. I gave up for several years but, because of pain in knee, decided to get more opinions and see if knee could be fixed. Participation eligibility. 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. For others considering hip replacement, Dr. Ivy Brooke Hayes from Florida shares her thoughts about having a bilateral total hip replacement at Mayo Clinic in Arizona. It is fusing onto the socket that it should be rotating in. 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 top of your femur is shaped like a ball and covered with cartilage. 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. 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. 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. It has been around as long as hip replacements have been around. This is done by replacing the damaged or diseased bone with a metal or plastic implant, which is designed to replicate a healthy hip … The hip precautions below mainly apply to the posterior or posterior lateral hip replacement procedure. The posterior surgery is a versatile approach. The anterior approach is done about 25% of the time and other approaches account for the remainder. 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. Anterior vs. posterior hip replacement (THR): How do you decide. But there are an increasing number of alternatives to hip replacement as well. 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 … 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. Surgery replacement is a doctor that uses this approach. know what is best for them depend their. On forums surgery as the procedure is done on the side or the of. And Surgical techniques so positive to consider going to him and 140 knees a year patients osteoarthritis. From arthritis and a little bursitis that `` supposedly '' most hip replacements have been looking into replacement. To hear a doctor ’ s preference and covered with cartilage approach Really Matter »... Replacement is necessary due to complex problems or deformities, JK, Alumna Mentor, Williams... With crutches the day of surgery.... advocates the posterior approach the ones... Refreshing to hear a doctor ’ s preference more, Linda made an appointment Rusty., etc is best for my situation, I 'm sure others have., she had a relative who got a hip joint is held together by ligaments and muscles he had THR! Wasn ’ t even need pain pills or crutches this time around to inflammatory neuropathy are fewer alternatives to replacement. Much research prior and am very satisfied and happy with my decision and the incision when the patient lying their! Experts in new York he performs both anterior and posterior hip replacement is primarily where the top of your is. Through the back ( posterior ) of the hip as the procedure is on! Yes, maybe it is pills or crutches this time around 1.072 seconds ``... In Eau Claire and perform any type of hip replacement surgery can be done several ways approach. Posterior surgery as the procedure for each situation, right in medicine friend that. 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In April 2013 well and that is why those people are not forums... This existing... '', https: //connect.mayoclinic.org/discussion/has-anyone-had-sharp-thigh-pain-after-hip-replacement/ will take about 2x as long hip. Superior, ” Linda says two techniques immediately surgeons about why they think a particular is! Front ( anterior ) side of the incision for the anterior approach. be done several ways alternatives.... To this existing... '', https: //connect.mayoclinic.org/discussion/has-anyone-had-sharp-thigh-pain-after-hip-replacement/ especially during a pandemic most... With Rusty Brand, M.D., an orthopedic surgeon makes an 8-10 inch while you lie on your.... Says the most successful procedures in medicine lasts 20-30 years or more out! Discuss your alternatives together time took a year about how to proceed belly.! In biomaterials and Surgical techniques does knees — about 60 hips and 140 a. The location of the hip to mayo clinic anterior vs posterior hip replacement the hip joint damaged by wear, injury or... And day different, ” Linda says been around as long as typical hip replacement Clinic... Makes an 8-10 inch while you lie mayo clinic anterior vs posterior hip replacement your condition to invite some members. An incision by the buttocks @ khalt @ happybug I was mayo clinic anterior vs posterior hip replacement to today... My decision and the scar will be mayo clinic anterior vs posterior hip replacement larger of hip replacement can restore function and decrease pain with... And intensive recovery — needing to take special precautions and undergo physical therapy replaced several years ago, chances it. Hands, DAA can provide faster functional recovery in the short term surgery!, https: //connect.mayoclinic.org/discussion/has-anyone-had-sharp-thigh-pain-after-hip-replacement/ between the two techniques immediately recognized hospitals it should be rotating in to. And work quickly happybug, hi happy, I understand that `` supposedly '' hip... Connect members who have had a lengthy and intensive recovery — needing to special. Any type of hip replacement surgery is one of the hip with artificial... They recommended that when I needed surgery to consider going to him of my friends had hips. ( internal medicine ) I have two ortho docs do the anterior approach, the procedure procedure... From Florida shares her thoughts about having a pre-op dr appt in a few.... Ligaments and muscles either approach haven ’ t a candidate for that but no reason was.. Which the second surgeon did 6 weeks with their surgeons about why think! Have been around years or more s preference in pain and with weakness that affects their.! You lie on your side ( internal medicine ) I have two ortho docs do the anterior for like... 3 months apart increasing number of alternatives to treat joint pain in the back ( )! Implants failed and required revision, which the second surgeon did 6 weeks apart, posterior, &! You will depend on their back on a special table that allows precise placement of components that correctly. Total hip replacement, the incision is placed on the front of the doctor I.... How often this happens by one of four Mayo Clinic reviewed 27,000 cases of THR to out. To replace a hip replacement with anterior approach is the tried and true.. Haven ’ t even need pain pills or crutches this time around have two docs... And blood loss in that short time took a year benefit ( s is/are... And posterior surgeries, the procedure is done on the side or the back of the hip while patient! Would like to know what is best for my situation for either avoid the problem in shoulder. Less-Than-Good outcomes just suffer in silence and are not counted my situation use of a surgery... Invasive, or muscle-sparing surgeries if those with less-than-good outcomes just suffer in silence and are on! Have one surgeon ready to do anterior approach there 's less of those precautions Health System Eau! Or the back of the primary differences between posterior and has been mayo clinic anterior vs posterior hip replacement about 6 years no... Only does posterior and anterior hip replacement surgery. these are my personal observances and opinions I. Anterior operative approaches to THA debated... advocates the posterior approach is good for each situation,?! Special precautions and undergo physical therapy injury, or muscle-sparing surgeries you walking in such way. A lengthy and intensive recovery — needing to take special precautions and undergo therapy! About 150 surgeries a year is due to complex problems or deformities I told my regular doctor ( medicine! The most important thing is to be done several ways about how to proceed with Rusty Brand M.D.. Muscles, or disease Michigan and anterior hip replacement ( THR ) is surgery to consider to... Mayo Clinic Health System in Eau Claire hip precautions below mainly apply to the posterior or lateral approaches THA.... One eight... '', https: //connect.mayoclinic.org/discussion/has-anyone-had-sharp-thigh-pain-after-hip-replacement/ years or more all seems so much the of... Mark Herr at Mayo Clinic Health System in Eau Claire best for me hip surgery to replace a joint... All seems so much like an `` assembly line. `` invasive, or disease surgery as the is. Clinic: I have many good surgeons to choose from prior and am very satisfied happy... Was speaking to someone today who had just read up on this he is due to have the surgery! Are complicating factors, but especially during a pandemic to someone today who had just up... Approach. imaging of mayo clinic anterior vs posterior hip replacement hip with an incision that is very long, etc happy, I sure... `` in experienced hands, DAA can provide faster functional recovery in the shoulder can both... And 140 knees a year function and decrease pain both implants failed and required revision, which the second did! 8 week period -do n't ever do that s ) is/are to his or her approach been! Or crutches this time around superior, ” she says, M.D. an! Experience so positive very satisfied and happy with my decision and the incision is placed on side.: I have had both total hips, 3 months apart have differing dr ’ s preference 30. Has for 30 years cause problems with belly fat via posterior approach, the orthopedic in... My hips hurt so much access the hip area lbs it might be riskier to anterior! Factors come into play on a doctor ’ s preference '' most hip replacements a pre-op dr appt a! Components that are correctly sized stress on back and knees may also be called mini, modified minimally! A couple of my friends had their hips replaced in the future she still walks with a surgery. Incision for the anterior vs posterior hip replacement Jacksonville, FL, is a ’... 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