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THR Anterior or posterior?

Blackbirdie

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Hi all

Sorry to start a second thread, hope it’s ok to do this?

I’m still putting my back into researching everything as I sit on the waiting list. At present, I’m down to have a posterior approach but I’ve been reading up about the anterior approach, and it sounds like a better recovery? However, it seems less common in the UK. I have emailed my surgeon’s secretary to ask if it could be offered and if he has any speciality in this field. If not, can I request another surgeon who does specialise in anterior, or am I confused in my views? I’m looking at having this done on the NHS, although I would consider going private if I had to.

Some advice from people who have had both styles of procedure would really help.

Thank you all
 

Jaycey

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I’ve been reading up about the anterior approach, and it sounds like a better recovery?
All marketing hype I am afraid. Approach really has no impact on recovery. In the "old days" surgeons imposed restrictions on patients who had posterior. However things have moved on and most surgeons don't do this anymore.

The end result is the same no matter with approach your surgeon uses. And do let your surgeon make this decision. It's all about which approach gives the best access to the hip joint.
 
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Blackbirdie

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Thanks Jaycey, you’re always so helpful.

Struggling a lot today. Tears and so unsure of what to do. Spoke to another hospital out of the area this morning on a personal recommendation, as the surgeon is a dysplasia expert. I’m not sure if my surgeon is, he hasn’t responded to that question yet. This is so hard, and I feel very lost...
 

Jaycey

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My friend any hip surgeon will know about dysplasia. It is one of the most common reasons why patients have THR. Both my hips had severe dysplasia and I had a different surgeon for each one.

Do you have an appointment with your surgeon anytime soon?
 

Eman85

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I've had 2, both posterior both with the same surgeon. I really didn't know which he used until after I had made my arrangements for the first. I asked the nurse where the incision would be. It's the approach my OS uses and that was enough for me as he is very competent. I chose him and he chose the approach.
 

GrannyC

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I had anterior but it was my surgeons choice, not mine. From what I’ve read, both methods have pretty much the same outcome. While some people have some minor restrictions initially with posterior, it doesn’t seem like a big deal and after a couple months they are at the same place as those with anterior. I think it is best to go with your surgeons recommendation. Some surgeons specialize in a certain approach and at times the approach chosen depends on the needs of the patient.

Since you are so apprehensive about all this, you may be overthinking the whole thing. It is definitely good to do the research ahead of time but some decisions I feel are best left to surgeon. Besides the surgeon choosing the approach, I feel it is also best to let him/her chose the new “joint” they will use. Again they have the knowledge and expertise and no amount of reading will give us the same first hand knowledge they have.

As long as you choose a surgeon who has plenty of experience and a high success rate, you will be just fine. You’ll get through this and eventually the day will come when you’ll look back and wish you had chosen to do it sooner because at that point you will have your life back pain free. Wishing you well!
 

Celle

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It's the approach my OS uses and that was enough for me as he is very competent. I chose him and he chose the approach.
That's the way to go. Choose the best surgeon you can find and let him/her choose the approach.

In any joint replacement, the most important factor for success is the skill of your surgeon, not the approach or the type of hardware that's used.
 

kimbarella

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I had anterior, I'm on day 28. my surgeon had done 2000 of these by 2008, then he stopped counting. So I had faith in his process. My scar is healing, the walking is slow going--I've reverted to a cane a bit more, though I do have moments of wandering the house without the cane. A close friend had posterior approach yesterday, so we'll be comparing notes. It has been a bit of a rollercoaster--no major pain, but pains that move around. I'd stopped icing about a week ago but I think I'll restart.
 

Layla

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Hello, I'm glad you joined us here!
I experienced Posterior approach, which is the only approach my surgeon was using at the time. I didn't have any restrictions. I was told to move slowly and let my body be my guide. If something hurt, stop immediately.
As mentioned, if you trust your surgeon, trust whichever approach he uses.
All the best as you move forward. :)
@Blackbirdie
 

leejaa

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I had posterior approach for both of mine. My OS said he was doing anterior for a while but found it did not change his patient's recovery so he did not see any advantage. I have had two great recoveries and everything I read here anterior does not really speed up the recovery process as the body has to take time to recovery from this major surgery. Pick your surgeon and have faith in his knowledge and abilities.
 

SarahBee

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I had anterior; a friend had posterior at about the same time. My recovery was absolutely uneventful and I progressed quicker than she did. That being said, now at nearly 11 months out, we are at about the same place in recovery.

I chose my surgeon because he did anterior approach. I am so very satisfied and blessed. But my friend feels equally happy with her choice. She caught up to me weeks ago so in the end, it only matters that you have a qualified, experienced surgeon who knows what they are doing, whatever approach is used. And that you are happy with the outcome! Godspeed!
 

Sweetpea39

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@Blackbirdie hello. I agree with above comments. Let the surgeon decide. My surgeon decided posterior was best for me with my build and the way my hips are situated. I was kinda bummed bc it seems so many people are having anterior. But I do trust him 100%.
 

Harpcat

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I too have dysplasia and had a posterior lateral approach in November. I am doing fantastic. At 3 weeks I was driving and this was my right hip. He does a ton of surgeries and I will let him do my other hip in October. It has 3 screws in it from a fracture which complicates things but I trust him implicitly and have faith it will go fine. Choose a doctor who has done a lot of surgeries and cares about his patients. You will be in good hands. Yes it is a bit scary at first but so well worth it and it’s normal to have some nerves and second guessing. Remember how common and successful this surgery is now. Please stop worrying and do it! My best to you!!
 
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Blackbirdie

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Thank you everyone for your kind and informative comments on both of my posts. The surgeon has called me in at the end of the month to go through the list of questions I sent him, he’s clearly picked up how nervous I am. Swinging back and forth between whether to do it or not, especially given my age. I’m having an ok time at the moment with minimal pain and my new PT has been brilliant and improved my range of movement somewhat, which isn’t making the decision any easier.

Having down days a lot still. Accessing a lot of support around anxiety and trying to keep fit. I’ll keep you all updated. Thank you again.
 

ForumUser

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Hi,

I had two posterior - both simply said the outcomes were equivalent - and, both said they liked the posterior better - and, both were relatively young surgeons - and, both were with large ortho clinics in different parts of the country. The only difference in the 20 years is that the recovery was far easier on the last one (May 2019), far less pain, far more mobility earlier, one vs three nights in the hospital, and almost ZERO pain after the one night in the hospital the second time - so, no narcotics at home - so, I was alert and positive from the beginning.

A friend of mine in another part of the country had an anterior - his surgeon only did anterior approaches. His recovery was fine, as well. I didn't sense he was "ahead" or "behind" me, just a bit different.

Either approach works just fine - some docs like one and do it exclusively so they and their surgical team are consistent. If one has specific medical issues it might determine which procedure, otherwise, it is just surgeon and patient choice.
 

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