Anterior hip replacement (AHR) is surgery to replace a hip joint damaged by wear, injury, or disease. The other only does posterior and has for 30 years. Answer: Hip replacement surgery can be done several ways. Why even suggest that then? Those revisions, and a subsequent one were all done within an 8 week period -don't ever do that! Thanks. In a posterior hip replacement, the procedure is done on the side of the hip. @khalt @happybug I was speaking to someone today who had just read up on this! Mayo Clinic has orthopedic surgeons with expertise in both anterior and posterior hip replacement. PA called back and said he wasn’t a candidate for that but no reason was given. “There is no right or wrong decision. Both say the operation will take about 2x as long as typical hip replacement and the scar will be much larger. 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. Anterior hip replacement is done with the patient lying on their back on a special table that allows precise positioning of the affected leg. 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. 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 other says anterior. Anterior hip replacement (AHR) is surgery to replace a hip joint damaged by wear, injury, or disease. 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. Linda had her total hip replacement in February 2012, with a revision surgery performed in April 2013. Las Vegas, Nevada 89149. The one who would use the anterior approach also does do posterior and has for about 14 years. I have had both hips replaced in the year 2018. The use of a fluoroscopy unit allows real-time imaging of the hip as the procedure is done. 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. This is not necessarily a bad thing, you want your surgeon confident in their method. Nerve palsy after total hip replacement (THR) is one of the worst. Ivy Brooke Hayes from Florida shares her thoughts about having a bilateral total hip replacement at Mayo Clinic in Arizona. 2017 I had total hip replacement anterior approach. 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. Learn more about services at Mayo Clinic. Anterior means front, and the incision for the anterior approach is made in the upper part of the front of the thigh. 5 common misconceptions about vertigo, dizziness, Advance directives: Always important, but especially during a pandemic. Cartilage is a tissue that helps joints move. 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 … “It was just night and day different,” Linda recalls. The big difference in anterior vs posterior hip replacement is primarily where the incision is made and how long it is. I am 53 and in excellent health. This allows precise placement of components that are correctly sized. These are my personal observances and opinions, I'm sure others may have differing. At 5 years both implants failed and required revision, which the second surgeon did 6 weeks apart, posterior. So what am I to believe? What factors come into play on a doctor’s decision to do anterior vs posterior hip replacement? 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. 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. Brand says the most important thing is to be comfortable with your surgeon and discuss your alternatives together. Print details ; Email; Share; Facebook; Twitter; Overview; Participation eligibility; Participating Mayo Clinic info; More information; Overview. Call (702) 731-4088 to make an appointment Northwest Office. We were told that no PT is recommended last time for hip replacement. The older Docs were trained in posterior approach the younger ones can do both but prefer anterior unless there are complicating factors. 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. Have you discussed with each surgeon what the benefit(s) is/are to his or her 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. In the posterior approach, the incision is placed on the side or the back (posterior) of the hip area. Simply click VIEW & REPLY to read past posts. If you want to buy Anterior Vs Posterior Hip Replacement Mayo Clinic 0 0 00 0 00 0 00 0 0 00. I'd like to invite some Connect members who have had each type of hip replacement. Linda had her total hip replacement in February 2012, with a revision surgery performed in April 2013. He had one THR a few years ago – posterior. 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. Some strength and flexibility work is helpful as well. The surgeries were done on her left side, and her surgeon used what’s called a “posterior approach” in both cases. If you have had a relative who got a hip replacement several years ago, chances are it was a posterior surgery. The top of your femur is shaped like a ball and covered with cartilage. Linda maintains it was the right method for her and thanks her providers for making the experience so positive. 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 wish you the best. Another advocate of the posterior approach, Miguel E. Cabanela, MD, of the Mayo Clinic, also reserves the anterior approach for some cases. Can anyone tell me any advantage of a posterior approach when the patient is a good candidate for either? The direct anterior group had a higher maximum visual analog scale pain score (5.3 direct anterior; ±2, … 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. With the anterior approach there's less of those precautions. 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. 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. He was walking with a cain the next day. 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. She also was able to walk sooner and had far less pain than her previous two surgeries. Instead they are willing to use whatever approach they use to handle every situation. Ed, were you a candidate for either approach? Las Vegas, NV 89113. Another surgeon ready to do posterior. 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. Direct Anterior vs. Anterolateral Approach for Hip Arthroplasty After Femoral Neck Fracture in the Senior Population. The hip joint is where the top of your femur (thigh bone) sits in the socket of your pelvic bone. I had the first one eight...", https://connect.mayoclinic.org/discussion/has-anyone-had-sharp-thigh-pain-after-hip-replacement/. A nurse friend just told us that she would never have the posterior surgery as the healing time is so much longer. Non-surgical options for treating joint pain They recommended that when I needed surgery to consider going to him. Dear Mayo Clinic: I have severe arthritis in my hip and have been looking into hip replacement surgery. Hello @happybug. Adult Reconstruction Fellowship. Tab Title Description. This will me my second THR. That should give you an idea of the recovery time involved. It would be refreshing to hear a doctor say: "You know. I was walking with crutches the day of surgery, and with barely a cane after 3-4 weeks, and dancing at 6 weeks. What I have found is that each surgeon has a preference and usually does one or the other but not both. 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. Proponents say it speeds up recovery time. One of the primary differences between posterior and anterior hip replacement is the location of the incision. The one who does hips also does knees — about 60 hips and 140 knees a year. 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. In the right patient, Dr. 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. 702-731-4088 . She didn’t even need pain pills or crutches this time around. The Anterior vs Posterior Hip Replacement Does the Surgical Approach Really Matter? Ivy Brooke Hayes from Florida shares her thoughts about having a bilateral total hip replacement at Mayo Clinic in Arizona. How do I choose? Posterior hip replacement surgery is the “traditional” approach to surgery. They also wanted to know what the risk factors are to help avoid the problem in the future. Basically, yes, what seems to be the situation is that ortho docs do the approach they like to use. Also, at the times of my surgeries, each doc had done well over 1500 hip replacement surgeries, so I had confidence in their skill. Hip Replacement Approaches Anterior, Posterior, Lateral & Minimally Invasive. 2016 I had total hip replacement via posterior approach. 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. What I want is the approach best for me. 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. The surgery went well, and Linda noticed differences between the two techniques immediately. 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 am writing for my husband. Doctors at the Mayo Clinic reviewed 27,000 cases of THR to find out how often this happens. It is fusing onto the socket that it should be rotating in. Hi @edmcrae, welcome to Connect. Posterior vs. anterior operative approaches to THA debated ... advocates the posterior approach to total hip arthroplasty. 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. A total hip replacement is a type of surgery. Are you doing physical therapy. Hi, I understand that "supposedly" most hip replacements go well and that is why those people are not on forums. Southwest Office. It all seems so much like an "assembly line.". 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) It has been around as long as hip replacements have been around. But there are an increasing number of alternatives to hip replacement as well. He is due to have the THR in a few days. Nerve damage resulting in nerve palsy can leave patients in pain and with weakness that affects their function. Yes, maybe it is a doctor’s preference. Please buy it from trusted store. Kate S. Hamilton, PA-C. Introduction. Anterior is a newer procedure. 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 Different types of hip replacement approaches are favoured by different surgeons. The one they chose to use on you will depend on their training, their experience, their personal preferences and on your condition. 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. @happybug , Hi happy, I had posterior 8 months ago. @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/. I've also read that it is important to find a doc who does a lot of hip replacements. 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. 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. 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. If you found fraudulent charges. 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. For many patients, the posterior hip surgery replacement is necessary due to complex problems or deformities. I have a femur head that is collapsed and has been for about 6 years. There are fewer alternatives to treat joint pain in the shoulder . “I’ve been really limited,” Linda says. JK. In anterior and posterior surgeries, the outcome is essentially the same — a new hip. Problems can occur after any operation. Aug 21, 2019 Richard A. The direct anterior approach (DAA), is a less invasive way of performing a total hip replacement. Would the direct anterior approach work for someone like me? The posterior approach is the tried and true method. 2016 I had total hip replacement via posterior approach. 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. Participation eligibility. The anterior approach for total hip replacement involves going in through the front of the hip, rather than the back. Small incision and little pain. Surely not every approach is good for each situation, right? Would the direct anterior approach work for someone like me? 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. I am sure that was partly responsible for my success. Dear Mayo Clinic: I have severe arthritis in my hip and have been looking into hip replacement surgery. @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? However, because it is locked in place, my back and my knee must do the movement and pain has developed in those two parts. Hi, @JustinMcClanahan Thanks for moving my post to the proper category. Historically, hip replacement surgery was performed utilizing traditional posterior or lateral approaches. During this traditional approach, the orthopedic surgeon makes an 8-10 inch while you lie on your side. Anterior vs. Posterior Hip Replacements. My doctor did the anterior approach. “I think it does have some advantages, but it’s just one of many surgical approaches that work for hip replacement,” he says. Hip replacement surgery is one of the most successful procedures in medicine. Are correctly sized she says she didn ’ t a candidate for either me. 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