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THR Pain vs. Covid: when to do THR?

Eman85

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As I said I can only speak for posterior as that is all I have actual experience with. My left had complications from the start as I had pins in my femur from 50 years before. There is no doubt to me that posterior gave my OS more room to work and remove those pins. Now my right was supposed to be a "chip shot" as my golfing OS put it. While in there he discovered a large bone cyst in my pelvis which he cleaned and filled while he was in there. Maybe the big hole in the side of my butt gave him more room and the ability to find that? I can't say for sure but it worked for him and me.
If you look at the pure mechanics of how your hip operates and what is done to install the implant you'll see the difference in restrictions and why the chance of dislocation is different. When they dislocate your femur at the hip socket they have to rotate it towards the incision. In the process they are stretching the muscles that direction. So when you are done the restrictions are to prevent stress on those muscles. It's my understanding with anterior the golfers reach and stomach sleeping along with pivoting outward are the restrictions for those reasons.
 

Mojo333

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The surgeon is definitely the first consideration and the fact that he is trained and confident with the approach he chooses for you.
Several members have had both approaches.
@Dublingal is one and I believe @Jelliott66 is another.
 

CricketHip

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I asked my OS regarding anterior. He had already done my other hip and both knees and this is his specialty. He said he did anterior for a while and found that the patients did not gain anything from anterior so he went back to doing posterior.
Wow--so your doctor said anterior surgery didn't have a good outcome? My surgeon seemed to be saying some hips require a posterior approach, but for others you can do anterior (which if possible is preferable due to having none of the post-op restrictions you deal with after posterior). Now I guess I need to do some reading on the anterior surgery. :chinstroke:
I don't think it's that anterior approach hips don't have a good outcome, but in the long run, they all heal at the same pace. I will say that with both hips the PT's commented when I walked in to be evaluated, that i must have had the anterior approach, based on my gait.
I have had both hips done with the anterior approach and did really well and am still doing well.

I have a physical job and was able to return at 8 weeks for both hips. Mind you, that meant seeing one client daily and sleeping/icing a lot! Luckily I am self employed and could manage my schedule.
I doubt I could have done so with a posterior approach, but that's just my opinion based on thinking about the 90 degree limitations.
I let my surgeon decide what approach was best for me.
 

Dublingal

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@Fennel .. I have had both approachs. Anterior on my left in 2018 and Posterior on my right in July this year. I too was born with dysplasia and my right natural hip was in pretty bad shape apparently. It didn't look so bad in xrays but my surgeon said it was one of the worst he has seen in 22 years so I guess that's bad huh :nah: I will say that although I'm struggling with a leg length difference right now and my pelvis is pretty offline (I'm praying these will resolve soon) the two approaches haven't been that different in the recovery process. I believe that if you trust your surgeon then you'll do better to trust his judgement regarding which approach is best for your individual case. Every single hip replacement surgery is different so it really doesn't matter too much what everyone else thinks. One thing... These folks here are appt in when they say PT is NOT necessary right off. I didn't have any PT with my anterior hip and had a great result. I did do PT with this posterior approach and now I wonder if all that is the reason my pelvis is completely off line. Listen to your body post op and please come back to this forum because you'll find everyone here has such a wealth of information :) Good Luck to you
 

zauberflöte

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@Eman85 a note here from a pair of anteriors re golfer's reach. I was not given that as a precaution at all. The op leg was the back leg, and I wasn't stretching the flexor area at all-- in fact the hip was still slightly folded or bent as though I were standing leaning slightly forward. If I understand your "pivoting outward" correctly, that was indeed something I should not do. "torquing the leg" they called it. It's not a natural move for me so that was not an issue.
 

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