Anterior or posterior. Not sure which way to go

[Poppet]

I would also like to reiterate that no matter the surgical approach, the surgeon still has to undertake the same procedure internally..

Saw off the top of one's femur, prepare the acetabulum, ream out the femur, maybe undertake reconstruction etc. etc.. and of course dependent on the individual there may be other procedures..

It remains as major surgery.. and complete recovery may take up to two years.. for some folk that time is shorter or longer, there may be complications, often frustration...

Also the level and length of immobility prior to surgery is also a factor... In my case 2 years draped over a walker, unable to walk more than 30 steps without sitting down on the walker... I remain delighted to be able to walk, but I also know that I still have a long way to go and on occasionally have to elevate and ice even at 16+ months post...

We are all different, but ultimately, we all want the same outcome... a shiny new hip that gives us back our quality of life..

 

[onlinebubba]

deb63 I researched minimal incision THA via anterior approach with OS's and in the literature; the advice above is solid. It's all about your OS's personal experience and outcomes data. The learning curve for DAA THA is steep; I recommend choosing an OS with at least several hundred cases for DAA minimal incision THA. For me, that meant flying to another state for surgery because I chose the most experienced surgeon (over 2000 DAA cases and over 200 MiniHips) that I could find with references from someone I know and trust. Any OS (any proceduralist doctor) worth her/his salt will readily share specific case numbers and outcomes (personal complication rates) with you; walk (run if able) away from one who won't.

 

[clifford149]

Hi....the problem with choice in the UK is that its nearly impossible to find out from NHS websites or private hospital websites what procedure is used what material components are used etc....you have to either speak with people that have had the op...or rely on your Gp (who may simply refer you to the nearest hospital)...I am assuming that as medicine is more market driven in the USA getting information about a surgeon is easier?

 

[zauberflöte]

clifford149 Medical pro's recommended my surgeon to me, maybe partly for his anterior experience. I've had 4 separate recommendations so far. I had to ask the nurse what implant he would use-- i didn't know to ask that when I first saw him, and the next time i see him will be on the operating table, at which time I sure hope I can't see him! His office's website tells about the anterior approach, but no more details than that. I don't think the hospital website has anything at all. But google is our friend...
I don't really know regarding other surgeons-- my only other surgeon was my gynecologist, and I trusted her implicitly (also I was very young and didn't know to ask....) You know what? Youth and ignorance make for quick recoveries LOL

 

[onlinebubba]

clifford149 Try contacting a national or international joint replacement society via website; you can register for free as a guest of many medical societies and access past and future meeting information (programs, topics, faculty lists, and even the audio and visual components). Maybe you can find a participant from near your home and contact them directly? Often the doctors presenting at such meetings are recognized thought leaders in their field and are quite experienced (that is why they are invited to present); they would be valuable reference sources because they are networked with other leaders in the field around the globe more often than the surgeon down the street.

 

[clifford149]

Hi ...that's a good idea...I did come across an annual USA conference held in hawaii ....with video..case study etc..often with different approaches contrasted to which at the end of the two presentations delegates were asked to vote for who was the most convincing

 

[onlinebubba]

broken link removed: https://www.jointreplacementspecialists.co.uk/JRS/Home.html
https://www.patient.co.uk/doctor/hip-joint-replacements
https://icjr.net/

These are a few sites that you may find helpful; I joined the ICJR for free and can access archived meeting presentations, including several by my OS, Dr. Stefan Kreuzer. Good luck!

Addendum: I realized after my post above that deb63 lives in NY USA and that clifford149 has already gone through THA in the UK; anyway-hope someone will find use in the site references

 

[Beccainnyc]

deb63, I live on Long Island and also went into NYC to have the surgery, specifically because of the surgeon who was recommended to me and because of the anterior approach. While I agree with what everyone has said about finding an experienced surgeon and having absolute faith in him/her, like sissy46, I cannot imagine choosing the posterior approach and all its restrictions in the early days of recovery. My surgeon did go over the risks you mentioned, but I've been fortunate to have had no numbness, no ankle problems, no femur problems. I walked with a cane the day after surgery-- I could have gone home that day-- and I stopped using the cane on about the third or fourth day home. No matter what approach you have, this is major surgery and the recovery takes time and respect. But not having those restrictions makes life so much easier. Extensive experience with this approach is the key-- my surgeon only does hip replacement, only does anterior approach, and has been practicing this way for about 4 years. He also uses the Hana table which seems to allow better access to the joint, and enables the surgeon to use X-ray guidance of placement, which minimizes the risk of leg length discrepancy. What my surgeon said is that after about 3 months, people who have had hip replacements are doing equally well, no matter what approach was used. But the anterior approach makes the early part of recovery a lot easier.

Barbara, I also have an appointment with davidovitch, however. I am seriously rethinking the anterior approach. Whom else were you recommended to in ny, I am starting to seriously freak out about the risks of thigh and nerve damage. The pain in my hip is so bad, my life is not the same. I am 47 and depressed. Please let me know whom else to go see. Thank you