The hip precautions below mainly apply to the posterior or posterior lateral hip replacement procedure. Direct Anterior vs. Anterolateral Approach for Hip Arthroplasty After Femoral Neck Fracture in the Senior Population. PA called back and said he wasn’t a candidate for that but no reason was given. The one who does hips also does knees — about 60 hips and 140 knees a year. Non-surgical options for treating joint pain Posterior hip joint replacement in Jacksonville, FL, is considered to be the “traditional” approach to hip surgery. I am sure that was partly responsible for my success. Her husband opted for posterior. Another advocate of the posterior approach, Miguel E. Cabanela, MD, of the Mayo Clinic, also reserves the anterior approach for some cases. 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 surgery went well, and Linda noticed differences between the two techniques immediately. Proponents say it speeds up recovery time. I did much research prior and am very satisfied and happy with my decision and the doctor I used. Total hip replacement with anterior approach refers to surgeries done from in front of the hip. Posterior vs. anterior operative approaches to THA debated ... advocates the posterior approach to total hip arthroplasty. … The last was in 2012, and I am doing fine, active and the only pain is from arthritis and a little bursitis. In the posterior approach, the incision is placed on the side or the back (posterior) of the hip area. @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/. My buddy same age as me had the anterior approach. I know each doc has his/her preferences, but I would like to know what is best for MY situation. 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. Yes, maybe it is a doctor’s preference. 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). 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. 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 use of a fluoroscopy unit allows real-time imaging of the hip as the procedure is done. For patients with osteoarthritis or that have experienced trauma to their hip, a total hip replacement can restore function and decrease pain. Study type Interventional Study IDs. 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. Skip to site navigation Skip to Content Search. 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. 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. 702-731-4088 . Author information: (1)Department of Orthopedic Surgery, Mayo Clinic, 300 First Street SW, Rochester, MN, 55905, USA, poehlingmonaghan.kirsten@mayo.edu. 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. Following her first two surgeries, she had a lengthy and intensive recovery — needing to take special precautions and undergo physical therapy. Introduction. 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. Hi @edmcrae, welcome to Connect. 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." Brand says the most important thing is to be comfortable with your surgeon and discuss your alternatives together. 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) 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. 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 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). Adult Reconstruction Fellowship. Would the direct anterior approach work for someone like me? 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. Dr. @khalt @happybug I was speaking to someone today who had just read up on this! Why even suggest that then? It would be refreshing to hear a doctor say: "You know. Tab Title Description. 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. 8402 W. Centennial Pkwy. 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. “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. The top of your femur is shaped like a ball and covered with cartilage. 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. Anterior vs. Posterior Hip Replacements. Doctors at the Mayo Clinic reviewed 27,000 cases of THR to find out how often this happens. Those revisions, and a subsequent one were all done within an 8 week period -don't ever do that! We were told that no PT is recommended last time for hip replacement. In a posterior hip replacement, the procedure is done on the side of the hip. Learn more about services at Mayo Clinic. The posterior surgery is a versatile approach. It all seems so much like an "assembly line.". Call (702) 731-4088 to make an appointment Northwest Office. 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… However, because it is locked in place, my back and my knee must do the movement and pain has developed in those two parts. And do the recommended exercises as instructed. A couple of my friends had their hips replaced several years ago by Dr. Mark Herr at Mayo Clinic Health System in Eau Claire. I think that with your situation, I would recommend you see a doctor that uses this approach." Healing time was about 2-3 weeks longer than for my cousin who had surgery at the same time. They also wanted to know what the risk factors are to help avoid the problem in the future. 2016 I had total hip replacement via posterior approach. Now I have two ortho docs who say they can replace my hip. Can that possibly be correct? How do I choose? 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 anterior approach is done about 25% of the time and other approaches account for the remainder. The big difference in anterior vs posterior hip replacement is primarily where the incision is made and how long it is. Anterior hip replacement is done with the patient lying on their back on a special table that allows precise positioning of the affected leg. Hi, I understand that "supposedly" most hip replacements go well and that is why those people are not on forums. 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. I moved your message to this existing...", "This will me my second THR. Anterior hip replacement (AHR) is surgery to replace a hip joint damaged by wear, injury, or disease. It has been around as long as hip replacements have been around. This technique involves cutting through muscle in the back of the hip to access the hip joint. My recovery time was far easier and faster. 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." I gave up for several years but, because of pain in knee, decided to get more opinions and see if knee could be fixed. The one who would use the anterior approach also does do posterior and has for about 14 years. Total hip replacement (THR) surgery has evolved into a highly successful procedure with tremendous advances in biomaterials and surgical techniques. They recommended that when I needed surgery to consider going to him. Any thoughts anyone cares to share? So what am I to believe? Proponents say it speeds up recovery time. These are my personal observances and opinions, I'm sure others may have differing. In 2006 I had both total hips, 3 months apart. This is not necessarily a bad thing, you want your surgeon confident in their method. 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. 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 direct anterior approach (DAA), is a less invasive way of performing a total hip replacement. 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 … With the posterior approach we give you certain precautions or positions to avoid for dislocation. The size and placement of the incisions will be different. During this traditional approach, the orthopedic surgeon makes an 8-10 inch while you lie on your side. Thanks. Dear Mayo Clinic: I have severe arthritis in my hip and have been looking into hip replacement surgery. Linda had her total hip replacement in February 2012, with a revision surgery performed in April 2013. 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'd like to invite some Connect members who have had...", "@happybug , Hi happy, I had posterior 8 months ago. 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. Posterior hip replacement surgery is the “traditional” approach to surgery. 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.’”. The joint is held together by ligaments and muscles. Yes, maybe it is a doctor’s preference. I have a femur head that is collapsed and has been for about 6 years. In anterior and posterior surgeries, the outcome is essentially the same — a new hip. 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. Will be having a pre-op dr appt in a few days. 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. In the anterior approach, the incision is placed on the front (anterior) side of the hip. Participants in the study were initially seen by one of four Mayo Clinic surgeons. My concern is that one says, for my situation, it has to be done from the posterior. The one they chose to use on you will depend on their training, their experience, their personal preferences and on your condition. 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. Hip Replacement Approaches Anterior, Posterior, Lateral & Minimally Invasive. Liked by Justin McClanahan, JK, Alumna Mentor, Debbra Williams, Alumna Mentor. So the one who would do anterior hips also does shoulders — about 150 surgeries a year. Can anyone tell me any advantage of a posterior approach when the patient is a good candidate for either? 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. 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. The other only does posterior and has for 30 years. 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 … Are those enough? Ed, were you a candidate for either approach? He was walking with a cain the next day. 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. A nurse friend just told us that she would never have the posterior surgery as the healing time is so much longer. It appears to me that it's a matter of the age of the Doctor. 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. Las Vegas, NV 89113. 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 other says anterior. The anterior approach for total hip replacement involves going in through the front of the hip, rather than the back. Sweet, M.D. This technique allows patients to recover and return to activities and work quickly. The joint is held together by ligaments and muscles. 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. Before Hip Replacement, Consider All Options for Treating Hip Arthritis. 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. Another surgeon ready to do posterior. Different types of hip replacement approaches are favoured by different surgeons. I don't want to endanger my already atrophied muscles, or get an infection from an incision that is very long, etc. 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. — A recent Mayo Clinic Proceedings article links some nerve damage after hip surgery to inflammatory neuropathy. 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. Total hips, 3 months apart at the Mayo Clinic Proceedings article some. 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