THR Nerve Damage with Anterior Approach

[HelenaM]

I had a right anterior replacement done by a surgeon who has performed thousands at a large teaching hospital. My recovery has been good in terms of function, but I have had a hard time with what has been diagnosed by several doctors as meralgia paresthetica. Later in the day there has been numbness and throbbing, although that has been fading away. My os said that scar tissue from the Incision was impacting the nerve (lfcn).
If I were to need another replacement, I would review all the approaches again and doubt that I would choose anterior for me, but that might depend on the surgeon I would find also.

 

[Coddfish]

I had the right THR with posterior approach 8 weeks ago. There’s quite a large curving scar, about 10 inch long, on my thigh. The surgeon separated my glutes but didn’t cut through them. He did have to cut the piriformis and a few other minor tendons. You can see my story in the post op area. I have had no problems at all, pretty well fully recovered now. The only obvious thing in the early days was a bit of weakness in my groin, from where things had been cut in that area. The approach simplifies the operation, it only took 50 minutes. As a result I had none of the bruising or swelling other people can suffer, and definitely no nerve damage. For me the thing I was more concerned about was to not be cemented, as I want to be able to run again, and understood that (assuming your bones are strong and healthy), being uncemented would give a better longer term outcome. The surgeon didn’t know whether this would be possible until he went in, as I am a post-menopausal woman so there is some risk of soft bones. All was well and I have an uncemented Smith + Nephew Polar 3.

 

[DGrant]

Hello!
I am having the anterior approach on Monday, Nov.8 and will be able to compare the two approaches as I had the posterior approach in 2015.
Hopefully all will go well and recovery will be better and faster. There are no guarantees in this business. Best of luck to all!

Hope you're healing well! I had my anterior May 5th, and couldn't be happier! Really from the start, yeah a bit of pain, and a few days weren't as good as most of them, but now over 6 months on it, along with my posterior(6yrs ago) I'm better than I've been in 10years or more.
There's harmony in hip land!
Best wishes on your continued recovery!

 

[Going4fun]

Sorry to hear of that pain. Sounds maddening and frustrating x 10!

All of the approaches, from what I can tell, have a risk of nerve injury. All approaches have tricky spots and challenges. Usually these problems are minor and pain recedes with time.

That's one reason it's good just to pick the best possible surgeon--because all the approaches have challenges, though the posterior folks love to say that they get a big view of the field, a bigger view of what they're doing than apparently some of the other approaches.

It's hard to know what to do. I can get why you might not want to stay with the same surgeon. Statistically speaking, I'm imagining that you wouldn't have this problem on the other hip if you were to do it--even staying with the same surgeon. But a difficult recovery and those complications you report... totally makes sense why you wouldn't stay with the same surgeon.

I once had a young woman in one of my classes who had a congenital back problem. She underwent surgery with a highly regarded surgeon, and the result was not good. She is in chronic pain. I still remember this woman saying something like her surgeon only had serious problems with something like 2 out of 500 cases ... and she was one of the unlucky two. A total fluke.

Doesn't hurt when time comes to visit other surgeons and see how you feel with them.

 

[Henrysmom1]

I had RTHR two years ago, anterior approach. I had nearly no pain after the surgery, save some mild incision pain. I had surgery 7am and was walking up few stairs by 1 and home in my recliner by 4. I only took a total of 4 Vicodin tablets afterwards and frankly it was to help me fall asleep. I did have pretty significant numbness on top of my thigh for several months after but it didn’t affect my legs function, but felt strange when rubbing or shaving my leg. I used a walker for almost 2 weeks, mostly due to my bad back, poor conditioning and preexisting neuropathy. Used a cane for a week or two after that but finally got to the point I’d forget to use it. I drove at 3 weeks and felt back to a better version of normal at about the 2 month mark. Would do it again in a heartbeat, in fact feel it’s nearly time for the other hip!

 

[Elf1]

@Henrysmom1 sorry but Curious George hasn't been on this thread since April 2021 so probably won't see this or answer back.I

Don't see a recovery thread either so I'm assuming he's left the forum.

 

[TomT]

Hello Curious George, I had my hip replaced with anterior approach and did experience, the nerve injury you are referring to. I just had a small patch of skin on my thigh that was a little numb, its not a big deal at all and a year after my surgery I can feel that its starting to fade and return to normal. I wouldn't worry about that issue.