anterior approach?

[frieds]

It's all about the surgeon and their experience with techniques. My posterior is 3.5" with zero bruises anywhere and healed super well and fast. I can't stress enough whichever works for folks I'm all for but the basis isn't the technique used - it's the surgeon! One anterior great doe one person and another person not so much (same for posterior). It's experience and finesse that can make the difference.

My only point is dont get hung up on type - choose surgeon you trust and who inspires you - the. Regardless of type of procedure you'll do great! I wasn't arguing for posterior - was right for me, not everyone. But I won't sit here and say anterior is superior either as some. It's the "newest way and gets a lot of attention and great results. I'm glad. But different strokes for different folks. Don't slam others for being passionate about helping others.


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[alexthecat]

As I said, there is more to a surgery than the surgical incision. Hip replacement and hip resurfacing are not the same surgery.

Prior to my own THR, I had several hip surgeries. I have had hip surgeries with posterior, lateral, and anterior incisions. My earlier surgeries were much, much more difficult and painful than my posterior THR, in spite of having an anterior incision. Why? Because those surgeries weren't THR.

Similarly, your resurfacing is not THR. The actual procedure that went on inside your body for resurfacing is not the same as for THR. You are not just recovering from an incision. You are also recovering from the surgical procedure that happened after that incision is made.

I feel like I'm repeating myself here. I don't have anything further to say and my online time is limited, so I will not be returning to this discussion. I do wish you well with your recovery.

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[Chessie]

I have worked professionally with many, many hip replacement patients, whose surgeons use various surgical approaches, including direct anterior. The overwhelming majority (more than 90%) are hospitalized for 2 or 3 days following THR. Occasionally the patient may have medical difficulties (usually unrelated to THR) that require a longer hospital stay. A shorter stay is very rare and, in my experience, usually dictated by an insurance company, not by a doctor.

Then things must be changing. The two people that I personally know that have had a recent THR, both went home within a day.

 

[alexthecat]

I personally know a great many more than just two people who have had THR. I work with them regularly. I've also undergone THR myself. In my personal and professional experience, hospital stays under 48 hours are rare. That is not something that is changing.

 

[waterman1]

This thread began by one asking if any patients noticed a difference between posterior and anterior surgeries. Boy did I notice a difference, and that is all I am relating. Posterior, I lost a lot of blood, had a huge hematoma, muscles and tendons were cut, and I had a large incision. Anterior, no muscles or tendons were cut, no blood loss, smaller incision. One hip THR, one hip BHR, sorry for wasting anyone's time. I wake every morning and thank god I no longer have arthritis pain in my hips and all I want is to walk again without assistance from anyone or anything.

 

[alexthecat]

Actually, this thread started with this post:

My surgeon is using a anterior THR, (ASI) technique, anterior supine intramuscular, no muscles cut during exposure of hip joint. Anyone have experience with this?

I don't see anything about a comparison of anterior and posterior approaches there.

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[Jamie]

Alex is right. The member asked for others' experiences with the anterior approach for a total hip replacement (not resurfacing). Let's please try to keep on topic, okay?

 

[psychteach]

It happens all the time. You try to answer their question regarding a technique and people who used different techniques need to explain why their technique is better. I agree stick with appropriate threads when responding. This is not a debate. People need advice on the technique they are using and what to expect and only those who have used that technique can answer that. They do not need to doubt the technique their doctor is using. Makes people more frightened .


LTHR Direct Anterior May 19, 2014

 

[Poppet]

Once a surgeon has made the first cut with the scalpel and is now into the THR procedure, the process will be the same.

The end result of a THR is a stem, a ball, a liner and a cup.. and the body heals in its own timeframe.

Healing Phases & Nutrition

We certainly can overdo it and set ourselves back in our recovery..

 

[waterman1]

Whew, you guys stress me out, I am certainly done. Thanks to all who helped me find a better surgeon. If you desire further details, you can discuss it on my thread, I think. This bilateral hippie stands corrected and is standing by...

 

[Chessie]

Actually, this thread started with this post:



I don't see anything about a comparison of anterior and posterior approaches there.

True. I am IN the preop class right now. They just stated, emphatically, that 95% of us that are having a single THR, will go home within a day and a half after surgery and most of THOSE are discharged within 24 hours. Now perhaps that is just my surgeon/hospital, but that is also what I was told by the other surgeon as well.

 

[Josephine]

This surgeon said the anterior lateral procedure is the same used by him for both THR and BHR, so as far as surgeries go, we are not comparing apples to oranges.

Well that's just as far as he is concerned. And a resurfacing is a much more major operation then a THR.

I lost two units of blood in that posterior surgery. Muscles and tendons were cut.

I very much doubt it. I have scrubbed for hundreds of hip replacements in all approaches and muscles are NEVER cut, the muscle bodies are just teased apart. You can see this when you carve a roasted chicken - the legs naturally fall apart into muscle bodies! The ONLY time a muscle body is actually divided or cut in half is the piriformis and then it's not always done.

The hematoma is large, don't you think? My whole butt is purple!

Not at all! Bruising after surgery is very common as you can see here Bruising after surgery.

The causes of this are various:
1. previous anti-coagulant therapy for some other reason such as hypertension (high blood pressure)
2. overly rough handling of tissue during surgery
3. poor haemostatis during surgery (sealing bleeding small blood vessels)

A common phenomenon mostly responsible for this is where blood pressure, having been intentionally lowered during during surgery, comes up naturally during immediate recovery cause the naturally formed clots on the small blood vessels (known as capillerioles) to blow off and allow some low grade oozing. This is generally harmless but over the next 2-3 days, the blood will diffuse into the adjacent fat, even going down as far as the knee and ankle. In general, nature will cause these blood vessels to clot again but the lost blood will continue to drain out and around the leg and may even collect in a space whic we then refer to as a haematoma. Like the general bruising, ultimately this all gets resorbed by the body.

I am telling you the difference is like night and day both in the hospital immediately after surgery, and today.

In your experience - but then that was what the OP asked! But please remember, your experience is a cohort of one and not representative of a larger sample.

 

[Josephine]

Then things must be changing. The two people that I personally know that have had a recent THR, both went home within a day.

Well yes, things are changing and surgeons do change their practice from time to time. It would be a dull old life if they didn't! Amongst the things most often vary from surgeon to surgeon is the length of stay. It can also vary from patient to patient. It's not an immutable, irrefutable fact!

 

[psychteach]

@waterman1 I so agree! Exhausting and not productive! Feel too great to battle ! Time to enjoy life you do too


LTHR Direct Anterior May 19, 2014

 

[waterman1]

@psychteach

 

[I'm finally gonna do it!!]

You go girl!, with your anterior approach and the surgeon that you trust to give you your life back! I haven't been on here much lately, but it is a wonderful "melting pot" of people with all different surgeons, approaches and recoveries. We all have our experiences with whatever approach was performed and definitely hold it dear to our hearts, it changed our lives! And it will for you too. Trust your surgeon with the recommendation he has for you, you will do great!