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SuperPath Hip Replacement?

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doghandler I looked for your thread, it appears that you haven't started one. I also had superpath surgery to replace both hips. I had mine in February and then the second one in April. I had a great experience with both although there is a healing process with all surgeries. Not everyone will be able to throw away the cane in a couple weeks, everyone heals differently and the worse the hip before replacement the longer the healing time. My two hips recovered at different lengths of time and still are healing. I had to use a cane longer than 8 weeks but I didn't care because the pain I had was gone and I knew the healing process was happening and as long as I let my body heal at it's own required time, I would be okay and I am.
 
I am new to this thread. I scheduled anterior method and was too afraid so I cancelled that surgery. Then I found superpath...and I am scheduled to see Dr. Grandic in late Dec and tentatively scheduled surgery for February 3. However, he is a 5 hour drive from where I live. My husband will stay in a hotel, I guess I will stay in a hotel after surgery, but not sure about how all this will work out. I am excited, yet still really scared. The leg length discrepancy is very scary for me, as I live in FL, and wear sandals all the time. Buying inserts for the other shoe is NOT an option for me....I am also age 50, so I have another 20 years of working I have to do. So this hip replacement is very scary for me. It has to be done because my left hip doesn't have any cartilage left...so here I am. I would like to hear from anyone who had any experience with Dr. Grandic. in FL and the superpath method he does. I especially would like to hear any experiences about the logistics of anyone who had to travel to have this surgery done anywhere, even if you used a different doctor, but had to travel to him. I would appreciate any words of wisdom.
FLgirlie
 
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FLgirlie said:
The leg length discrepancy is very scary for me, as I live in FL, and wear sandals all the time. Buying inserts for the other shoe is NOT an option for me....
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FLgirlie,

Good luck on finding the right surgeon for your surgery. I just wanted to clarify for you that the use of the anterior approach significantly reduces the chance on having a leg length discrepancy. With the anterior approach the surgeon will be able to use live fluroscopy to "visualize" the length of your legs during the operation. This added ability is the major reason that I switched from using the posterior approach to the anterior approach approximately 1 1/2 years ago.

Orthodoc
 
Thank you Orthodoc for your comments and concern. Your information is exactly what I have read in other sources. I do hope that I make the right decision and find the right surgeon and the right method. The most experienced doctor in Tampa for the anterior method has done 250. At least that's all I have been able to find here. I have made 15 phone calls to other places in the area trying to find another more experienced doctor for a 2nd opinion and can't find one. Part of my reason for cancelling that surgery was the lack of choices in Tampa and I just wasn't sure he was the right doc with enough experience. Dr. Grandic has done over 600 of superpath. I have talked personally to 2 (I know, not very many) of Dr. Grandic's patients and they say that they had the same concern of LLD, and he assured them that LLD would not happen on his watch. It didn't for them. How he does that, I'm not sure, but he has a method that apparently works for him so that LLD doesn't happen. I will ask MANY questions about this at our first consult with Dr. Grandic, but I will admit that I am still learning about both methods. I am also going to meet with the Tampa ortho doc again on the anterior method, as I have many of the same questions for him that I would like to clarify. Then, the issue of nerve impingement/pain...I have read a lot of complaints of nerve impingement/pain long after the anterior method is done...My understanding is that the nerve pain/issues are highly unlikely using the superpath method....
I think its maybe a matter of getting the right doctor. Yes, It's overwhelming and mindboggling.
Any additional information you can share is greatly appreciated.
 
doghandler First of all, WELCOME to the group! You'll find great help, support and understanding here.

I had leg length discrepancy all my life. My surgeon evened up my legs during my hip replacements. It does take a while for your body to adjust to the new leg lengths and for me, it feels kind of clunky and off, but I'm assured that that is because over a lifetime my muscles, tendons, etc. had adjusted to my legs being a bit off (I wore shoe inserts to come close to evening up the legs), and now everything has to adjust back to being level. Evidently there are a huge number of muscles, etc. involved in walking, the tilt (or not) of your pelvis, etc. I'm having funny pains come and go in funny places, and my knees feel weird, but as I understand it it is part of the healing and adjustment process. I am still (on OS orders) using a walker, bur I'm doing better and better. Trying to work on my gait to be sure I get rid of the long-learned limp. It is a long, slow process, I'm learning, but well worth it to get rid of that awful bone-on-bone pain that was consuming my entire life.

Please let me know if you have any questions I might be able to answer, and keep us posted ;how you are doing. You're among friends here.

Peace and love to you.
 
FLgirlie, You have made the right decision in choosing Dr. Grandic!!!!! You will absolutely not be disappointed. He did my right hip replacement and will be doing my left hip on Jan. 8th. He is the one who told me that I absolutely would not have a leg length discrepancy. He can visualize it perfectly through the catheter that is inserted into your leg (the half-inch "stab wound") and that guides the surgery. He is a brilliant surgeon and has always been right on target in telling me what to expect. I've heard the same thing from other patients of his, as well as from nurses, physical therapists, other orthopedic surgeons, etc. Here is a link to a really wonderful YouTube video of one of his patients just days after hip replacement, dancing with his walker. I couldn't dance like that after surgery -- but I never could dance, before or since! If you want to speak to me by phone, send me a private message and we can connect.

 
FLgirlie, The video was made three days after surgery. (The comments the guy wrote on YouTube don't show up on the Bonesmart site, but the video is intact.) You may want to stay in a rehab facility for about a week after surgery, since you are from Tampa. If your insurance covers it, that is one possibility. There are some very good ones here. When you see Dr. Grandic, ask him to explain the difference between what he does and the anterior approach. I think it will be an eye-opener for you. Good luck!
 
FLgirlie said:
I have made 15 phone calls to other places in the area trying to find another more experienced doctor for a 2nd opinion and can't find one
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You may want to consider Dr. Joseph Locker in Ocala, Florida. He is relatively close to you. broken link removed: https://www.toi-health.com/locker.aspx He is a high volume anterior approach surgeon. He also teaches others surgeons and is very skilled in the OR.

Good luck in your search. Regardless of the approach, hip replacement should significantly improve your life.

Orthodoc
 
FLgirlie, I just remembered that marcopollo (who had his surgery the same day that I did) had to travel from Northern to Southern California -- I think more than five hours -- for his surgery at Stanford. I have tagged him so that he can tell you about how he handled having surgery some distance from home. I think it all went very smoothly for him.

Re: Dr. Grandic, a couple of other things... In addition to doing hip and knee replacements, he is also a top revision surgeon in this part of Florida. He did a very prestigious fellowship -- the Aufranc Fellowship -- at New England Baptist Hospital, one of the top orthopedic hospitals in the US, affiliated with both Harvard and Tufts Medical Schools. He was very involved in the development of the SuperPATH process, and trains other surgeons.

I wish you the very best of success, whichever approach you choose to take. I shared your fear about possible nerve damage as a result of the anterior approach, and I had also heard that there was a higher-than-average risk of bone fractures with anterior vs. other types of hip replacement. I have friends who had successful anterior replacements, and were thrilled with the results, but I didn't want to take those risks.
 
BeckyR
Please forgive my lack of knowing how to use the forum, but I would like to connect with you. I tried to PM you but the PM option does not appear to me anywhere. When I click on your profile, the ability to PM you does not appear. I tried the help section and it seems easy enough, but the option to PM doesn't appear for me in any of the ways the help section suggests. Any ideas what I need to do to be able to PM? If you can PM me, please do, and I'll contact you right away.
 
FLgirlie, Last post for now -- sorry to pepper you with things, but I keep remembering things you might want to know. With SuperPATH (at least through Dr. Grandic) you won't have any stitches or staples needing to be removed. He closes the incision with glue, so nothing needs to be removed. The incision is 2 1/2 - 3 inches long (mine was 3"), plus the half-inch "stab wound." It looks like a papercut, not like a surgical scar. Within three months after surgery, I had no sense of ever having had my hip replaced -- it moved and felt entirely like a natural hip.
 
Oh Good grief...I just googled my PM problem...apparently I can't PM until I have 10 posts.

"You will be unable to initiate a private message in this manner until you have 10 posts on BoneSmart. So I suggest you start reading some of the threads in an area that interests you and start communicating with your fellow BoneSmarties."
 
Thank you so much BeckyR, all the information you have is soooo helpful. I got your PM. Thank you so much. It appears that you have had excellent results and have no regrets. Everyone I have talked with that had Dr. Grandic has said the same. There is something to that. The ortho doc in Tampa that does the anterior wouldn't provide references, but every other ortho I know of does. I thought that was weird too. Gave me a bad feeling about the doctor and left me with no other options in Tampa.
And Orthodoc,
I will check out Dr. Joseph Locker in Ocala, Florida. I can't tell you how difficult it is to get any information on doctors around here. It's nuts!! I was serious about the 15 phone calls I made. Odd, my Tampa ortho surgeon said there was no one else in all of FL that has done as many anterior surgeries as him (he has done 250 but I don't think that's a lot in the big scheme of things). I even tried the Mayo Clinic in Jacksonville, and no luck there either. Thank you! You just helped me find an excellent surgeon in an instant!!
 
BeckyR said:
With SuperPATH (at least through Dr. Grandic) you won't have any stitches or staples needing to be removed. He closes the incision with glue, so nothing needs to be removed.
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Anterior approaches use glue also. I don't believe that is an approach issue...it is a doctor preference.

ETA The superpath approach does sound appealing. Good luck with your decision. I had an Anterior approach. I found the recovery to be more difficult than I expected. I was walking unaided and driving by two weeks, but I certainly was not out golfing! LOL Not that I golf, but that is what you read about online.
 
FLgirlie BeckyR I am also a strong advocate of the superpath technique. I feel that it is right for everyone but there are few surgeons that perform it. It is the least invasive THR there is and that is because of the "path" that is created during surgery to allow tools to come from another angle under the larger incision to assist with the surgery. I had both my hips replaced within 6 weeks of each other. I had zero restrictions, I was up walking, within a few hours of surgery. Stayed in the hospital overnight and went home the next day. I had over a 3 hour drive home from the hospital. Saw the doctor after each surgery at day 10. After the last surgery I was cleared from seeing him for a year. I did do PT but after the second surgery and a few PT sessions I felt I needed more healing time and the PT was interfering with that so I dropped out. I have been getting stronger as time goes by. I feel we try to rush the healing too much by expecting our hips to return to pre-problem condition in a matter of weeks after surgery. I was told and have read, it could take over a year to heal completely. It doesn't matter what technique you go with for surgery, the parts being replaced are the same and it takes time for all that to heal. With superpath there is less trauma to the joint which is good for the surrounding muscle and tissue, I didn't have any bruising at all.
 
calikat, sandybeach, FLgirlie, Good to know that the glue is a surgeon choice and not just SuperPATH. It really is nicer not to have any stitches or staples, if that can be done. I think that there MUST actually be more people doing SuperPATH than the 10 listed on the Wright website, because all of the Aufranc Fellows (5 per year) are trained in the approach at New England Baptist, where it was developed. Plus, the people currently using the approach train others. Dr. Grandic, Dr. Jimmy Chow in Arizona, and Dr. Pennenberg (sp?) are three I know of who are involved in training others. I just found out that there is now at least one surgeon in Sydney, Australia using SuperPATH -- trained by Drs. Chow and Pennenberg. Apart from the Wright website, however, I don't know how people would go about identifying doctors who use SuperPATH and how much experience they've had with the approach. It is definitely the least invasive method, and the most flexible. Surgeons can use any implant on the market for SuperPATH, whereas there are limitations in which implants can be used with the anterior approach. If there are complications, SuperPATH can be converted on the spot to a traditional posterior approach THR. I agree with Sandybeach that we all have to be willing to let our bodies heal at our own pace. Everyone is different.
 
BeckyR If you speak with some anterior specialist surgeons, I think many of them will disagree with some of your assessments. I spoke with three surgeons, and they all have their own opinions about what is better, least invasive etc.
 
calikat, I know that there are others who would disagree with what I've said. I'm not a surgeon. My statements are based on the research I did before my own surgery, and journal articles I've read about the risks associated with the anterior approach (e.g., nerve damage, additional risk of fractures). I have friends who had THR done with the anterior approach very successfully, and who swear by it. I'm also going by the explanations my own surgeon gave me about how SuperPATH is less invasive than the anterior approach. This isn't something we need to debate. We can agree to disagree. Here is a link to an article about the high rate of complications with the anterior approach, from the National Institutes of Health: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3018203/
 
BeckyR I am not really disagreeing, I am just saying that each OS is going to have his opinion about what is best, and it is probably the surgery that they perform. I saw three and they each had three different opinions. There is also a learning curve for doctors performing the "superpath" technique. I saw a surgeon in Santa Monica who uses an approach similar to the SP, but does not call it that. I believe if you use the SP name you have to use the wright implants system? If I had not been so desperate for my replacement I may have gone to see Dr. Penenberg in Beverly Hills...but another deterrent was that he does not contract with any insurance.
 
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