different kinds of minimally invasive hip surgeries?

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leilag

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Hi - Can someone help explain the different levels of minimally invasive THR? Last March I had my right hip done with a minimally invasive surgery. I felt great, and was really proud to be off crutches and on a cane after about 5 weeks. A colleague then had minimally invasive surgery with another doctor - and was walking within an aid within 2 weeks.
So for my other hip, I went to her doctor (actually his colleague). They both use the <!--[if gte mso 9]><xml> <w:WordDocument> <w:View>Normal</w:View> <w:Zoom>0</w:Zoom> <w:PunctuationKerning/> <w:ValidateAgainstSchemas/> <w:SaveIfXMLInvalid>false</w:SaveIfXMLInvalid> <w:IgnoreMixedContent>false</w:IgnoreMixedContent> <w:AlwaysShowPlaceholderText>false</w:AlwaysShowPlaceholderText> <w:Compatibility> <w:BreakWrappedTables/> <w:SnapToGridInCell/> <w:WrapTextWithPunct/> <w:UseAsianBreakRules/> <w:DontGrowAutofit/> </w:Compatibility> <w:BrowserLevel>MicrosoftInternetExplorer4</w:BrowserLevel> </w:WordDocument> </xml><![endif]--><!--[if gte mso 9]><xml> <w:LatentStyles DefLockedState="false" LatentStyleCount="156"> </w:LatentStyles> </xml><![endif]--><!--[if gte mso 10]> <style> /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman"; mso-ansi-language:#0400; mso-fareast-language:#0400; mso-bidi-language:#0400;} </style> <![endif]-->antero lateral process for incision, so the second surgeon couldn't explain what the difference was in his surgery procedure v.s. my original surgeon.
Does anyone know the difference?
 
Hello leilag, welcome to BoneSmart. So glad you found us.

I'm not a medical expert so can't give you a technical answer to your question. But I am sure Jo or Jamie will be along soon to give you their input.

For now can I suggest you get familiar with the information in the Library (see top header bar for the link)? You will find lots of information there.
 
Hi, leilag....welcome!

There really are no "levels" of MIS. Each surgeon develops his own techniques, so they are somewhat unique to the individual.

But more importantly, I think you need to understand that RECOVERY can vary widely from one procedure to another. Even when someone has bi-lateral surgery done at the same time by the same surgeon, one hip can be more difficult, painful, swollen, and slower to recover than the other.

You are much better off not to try and compare yourself to anyone else. Find an experienced surgeon that you "click" with and go from there. Your body will do its own thing in recovery. If you like this second surgeon better than your original one, go with him for the second hip. But....don't expect that you will automatically be off crutches in 2 weeks. Your healing schedule may be entirely different. There are MANY variables to recovery.
 
Thanks for your answer. I'm not trying to compare myself to anyone else, but I am trying to compare doctors! It helps to know that each has their own process. I live in a small rural state, so the surgeon choices are limited. I am trying to understand the difference between a minimally invasive surgery that predicts 6-8 weeks until one is off walking aids, and one that predicts 2-4 weeks. That's a big difference, yet both call their methods minimally invasive. (and the surgeon doing the swifter method is 2 hours away - another big difference....)
 
That's nothing to do with the actual surgery, just down to the surgeon's own protocols. As Jamie and Jaycey said, each surgeon has his own way of doing things and sometimes the differences are significant. For instance, with an uncemented prosthesis, some surgeons require their patients to be on crutches, totally non weight bearing for around 6 weeks whilst others have them fully weight bearing from day one. There is no real rhyme or reason for this - just their own take on things and what they think seems to work best.
 
Dear Leilag,

I got here 7 months ago totally uninformed and trying to find any reason not to proceed. The crew at BoneSmart set me straight. I did my research and now I'm scheduled for an Anterior THR on 1/31/11. All joint replacements are serious major surgery...The Minimal in MIS is purely relative. The Anterior approch generally involves less cutting, moving and disturbance to the muscles, tendons, etc. This technique is still not available as widely as some of the more traditional methods because of the specialized and expensive equipment and the extra Doctor training.

I'm fortunate to live in Houston with a large selection of OS's and Hospitals. I have great expectations for the results. Doc tell's me to expect a 2 day Hospital stay, go home under my own power and have little or no PT or restrictions, drive in 2-3 weeks and go on a cruise in April(?). I hope he's right and will keep everyone posted if it works as advertised.

I found that a number of procedures are classed as MIS. You need to do some research to understand the differances. Thoroughly check the Web, the Library and Select a Clinic tabs for Doctors and Hospitals. Appreciate your out in the country, but many folks here travel far to get the perfect Doc.

If I can be of any help just let me know. Check some of the recent posts in the PreOp forum.

Best of Luck
 
Good luck with your surgery - with any luck you'll be like me and feel like a new person, able to move on with life without pain. I waited years, believing I could fix my problem by exercise, diet, posture. I had surgery on my right hip last spring. Now I'm trying to do the right thing for the second hip (and grateful that humans have only 2 hips to worry about!).
Thanks for your answer.
 
Dear leilag,

Just a follow up to our last coversation. I had my Anterior Direct Approch THR on last Monday 1/31. I've got the details in my thread "Jack is Back". Basioally, the results todate exceed my wildest expectations. Out of bed the same day, walking without assistance the next day and strolled out of the hospital on Wednesday.

I have no walker or cane, no PT and no restrictions except not to attempt a "punt" type motion. The staples come out next Thursday and I don't see the doctor for 3 months.I am taking very little pain meds and should be off completely in 5-6 days. These results may not be typical, but obviously are possible. I'm 68, no fitness freak and have simply not delayed in getting the operation and have been dilegent in following instructions.

Talk to your Doctors about the details of what he does and ask about PostOp protocals. If you have the opportunity to get the same procedure I got I'd reccomend you go for it.

The final outcome of all the procedures is likely the same. I am just very grateful that I'll get there much sooner.

Best of luck.
 
I would like to second Jack's comments on the Direct Anterior Approach. My results have been just slightly less "miraculous" as Jack's...however, they have still far exceeded all of my expectations.

My incision is about 4 inches long (which is incredible in and of itself considering all that is required in THR). 2-3 days post-op, the muscles in my thigh were sore, aching, bulging and loose in places I didn't even know I had muscles! But now I'm only 12 days out of surgery and walking quite easily without a cane. No restrictions post-op (other than common sense, of course). I'm still taking pain meds and icing frequently, an I believe this is aiding my progress.

While everyone's experience is unique, I truly believe the DAA can give you a reasonable shot at a recovery that will exceed your expectations based on my own experience and reading Jack's posts. I'm nowhere near "back to normal" yet, but I consider my own experience so far quite amazing! If you can locate an OS with experience using the DAA, I would highly recommend talking to him/her as you interview your OS options.

For another set of input on the Direct Anterior Approach from a manufacturer, here is a link that has an animated video explaining the DAA, as well as a comparison between "traditional" THR and the DAA: http://www.aboutstryker.com/hip/procedures/procedures-daa.php


Dan
 
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