almost there -Anterior Approach Surgery

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zack10

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I am 50 years old and I had a kidney transplant ten years ago and because of the Prednisone I have to take, I have avascular necrosis. The last few years was very hard. I barely can walk and the pain is intolerable. So I decided to have the anterior approach but I have some doubts about it.

From what I read on this approach, its better than the traditional hip replacement but some doctors told me that in the first 5 years after the surgery there is a 15% chance of nerve injury and of revision in the first 5 years. Is it true?

I am so confused I don't know what to do. Which method is better for the long term. Please help me. I have to decide soon. I prefer the anterior approach because the recovery is better, there are no restrictions, no difference in leg length and the pain is less.

Any suggestion will be gratitude. Many health to all of you
 
Zach, when is your surgery?

I'm a new 'future hippy' and still learning about hip replacement/resurfacing issues. I've read a bit on the anterior approach and watched a couple of those surgeries on youtube. My understanding is that surgeons can perform an anterior access and stay a good inch lateral to the nerves and vasculature that runs through the anterior of the hip. My understanding of the need for revisions after the anterior approach is that that occurs because it is harder to properly place the cup.

In your shoes I would quiz my surgeon on 1)what he does to ensure there is no nerve or vascular damage and 2)what steps does he take to ensure that the cup is properly placed.

Good luck!
 
:welome: gentlemen! I had anterior hip surgery in April and had such amazingly fabulous results that I decided to have my other hip done in October. I will be 8 weeks tomorrow from the second surgery and an unbelievable 8 months from first.

I had long refused to have or even consider surgery with the old approaches (both lateral and posterior) because of the long recovery and short and long term restrictions. I own my own business and could not even imagine the financial ramifications of closing for two weeks let alone two months. For so long, I saw no gain with having surgery because of the lifetime restrictions. A few of the reasons I chose anterior
  • shorter recovery
  • less long and short term restrictions
  • incision/wound in front where I could see and care for it myself
  • smaller incision
  • less soft tissue damage
  • no lifetime restrictions (many tho do warn against running as primary form of exercise
I now know from here that today's techniques for hip surgery no matter the approach are vastly improved and different from most impressions. You can read about remarkable (and not so good) recoveries on here from people with different approaches. Both of my surgeries had absolutely phenomenal recoveries and results (so far)!

I do remember asking about revision as some of the posterior approach surgeons I saw suggested that a less stable joint was greater probability with anterior because of the shorter stem. I was entirely comfortable with that the Biomet stem was just as long as the one used for posterior. My surgeon also explained that he could get a larger top cup with anterior and felt that range of motion was therefore better.

As far as nerve damage, my left thigh from the first surgery does have an area about 1.5 inches by 6 inches of numbness just to the outer side of incision that may or may not go away. I asked my surgeon about it at my most recent post-op check since my right thigh has just a tad more numbness in just 8 weeks. He did acknowledge that left thigh may retain this numbness and explained that the "nerve damage" occurs more because of damage from the retracters used rather than actually "cutting the nerve." It is a small price I may pay. To be honest, I rarely notice it. It does not affect the way I walk and I don't feel it unless I actually touch it, and even then I don't "feel" it :heehee: .

The rewards of a really and truly second chance at life that this surgery gives are just moment by moment, day by day so phenomenal! Take time to read the recovery stories --- there is so much more good than bad. Best wishes to both of you.
 
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My experience with Anterior hip replacement was just stellar! I was up and out of hospital noon the next day... walking about up stairs and down like nothing had been done. I actually felt like I had not had any surgery... only the incision gave me a clue! Within a week I was barely using the cane... and felt like I had never had surgery other than the pain was GONE. Just amazing. Now at almost 3 months out from surgery, I am doing everything I want to do, no pain, and feeling terrific! I have the typical numbness on my thigh... no big deal. I have some numbness also on both knees from my knee replacement. I do not notice the loss of sensation unless I touch the area. When I have my right hip done down the road.... it will be anterior all the way.:yes: joan
 
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I had long refused to have or even consider surgery with the old approaches (both lateral and posterior) because of the long recovery and short and long term restrictions.
I had lateral approach THR just under 10 weeks ago. No restrictions and I am back to work full time. I have none of the numbness that most people experience with anterior.

Frankly, all the hype about anterior is just that. There is no long term benefits to any approach. The key to this decision is your surgeon. Find someone who does 200+ THRs per year. Let them make the decision about the prosthesis and approach. They are the experts.
 
From what I read on this approach, its better than the traditional hip replacement. Which method is better for the long term.
What you call 'the traditional' approach is just other options. There is a lot of hype about this when the plain fact is that they are all pretty much the same. In 6 months you will care less which approach you've had anyway! Good outcomes are obtained equally from all approaches.
some doctors told me that in the first 5 years after the surgery there is a 15% chance of nerve injury and of revision in the first 5 years.
Untrue. It was thought so about 15-20 years ago but things have moved on since and it's no longer true. Sadly there are many surgeons who are not so well informed (and websites) and keep chanting out the same old 1990s stuff!
I prefer the anterior approach because the recovery is better, there are no restrictions, no difference in leg length and the pain is less.
Again, you are falling for the old, old hype. Recovery is not all that different from one approach to the other. I have known dozens of hips surgeons over the years and VERY FEW impose restrictions. Leg length differential is more about you than the approach or the surgeon. Read this Leg length differential - LLD
 
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