Don’t know what to do

Im sorry this happened to you. I agree this has been a total mess. I stopped myself from posting because I see so many success stories and it I didnt want to scare anybody off. But I've only traded one pain for another and its just as bad if not worse than before. I get so discouraged at times.

i cant flex my foot upwards so my toes drag on the ground without the brace. My shin and top of foot are completely numb. surgeon told me the same thing about the block. serious muscle loss. yeah i feel you. Thing that gets me most is eveyone talks about therapy and how important it is but I received 3 days thats it. Then it just felt like they were just rushing me out the door like ignore him and he'll go away or something.

thanks for this information. that is the main thing about anterior that scares me with the nerve. when searching on the internet for anterior approach risks, the nerve damage does show as being common. i think i will continue to take supplements and manage pain (currently down to almost none during normal activities) with my moderate arthritis, and continue low impact exercises with weight training. i used to be able to run, jump, stairmaster, etc. no more, it will tear my hip up.

i hope the superpath method gets more popular; from what i can see it is the best method with the least risk - that is an assuption of course since it is so new.good luck to you both, i hope you get better.

There have been some problems on this board with Super Path too. Someone wrote:

I had a hip replacement at Coventry Hospital in August 2017 and came round from the operation in severe pain. I was told that my surgeon had used a modern technique called Superpath and I was likely to recover more quickly than expected. The surgeon, Michael Cronin, had not discussed this technique with me, and I would not have agreed to the technique had he asked my opinion. My severe pain was ignored, even though it was a sharp contrast to the lack of pain in other patients whose surgeons had used more traditional techniques.

Six months later the pain hasn’t gone. I have been in severe pain 24/7 since the operation. My mobility is worse than before and the hip seems to move and click. My foot is numb and I have pins and needles in my back and leg. The response from them hospital has been slow and reluctant and I’m told my surgeon has now left the department.

I have seen on this site that at least two other people have had the exact same experience with this surgeon. Would love to know if anybody else has had the same problem and whether the situation has improved over time.

ouch... well that does not give you confidence in the surgeon that is for sure. i did watch the superpath video and it seems more complex from a tool and procedure perspective. the benefit of it from what i can tell is your going in from the side avoiding the femor nerve and are not cutting so much ligaments around the hip joint/socket for faster healing. but again, it is new from what i can see.thanks for the info, i will continue to manage and watch progression in the field.

I did read some article on the various methods and the result was that in the end the results were much the same.

I am so sorry Keith, you would have thought things would be so much better by now. It does seem that the anterior approach can cause some nasty nerve damage. I had the posterior approach and my surgeon was brilliant, not the best bedside manner but brilliant at operating.

out of curiosity, do you guys think the nerve damage is caused primarily by the surgeon skill level, the approach used, patient body type, or some combo? some people seem to climb mountains the next day and others struggle. always interested in leading cause for the struggle to reduce risk.

I think it may be a combo. Surgeons often prefer the posterior approach as they have more room for manoevre with less chance of causing nerve damage. I assume that their attitudes may change when a patient has a big problem after an op they did.

I have been a home health RN for 24 years and in all that time I never saw anyone who had problems with the surgeon I used. He was the first surgeon in our area to do the anterior and I took care of many of them who praised him and the procedure. So when it became my time for a hip replacement I researched it and even watched the procedure on You tube. It seemed straight forward enough and I loved the fact that the healing was quicker. So to answer your question Charlie2018 I think I just drew the unlucky straw. I told the surgeon I do not blame him, I do not think he was careless, but he to this day, 8 months later, will not acknowledge that it happened during surgery. I had a special MRI neurography that shows only the nerves and it showed that the damage was right at the site of the surgery. But he still says "It's not my fault, I'm only the carpenter". I told him his carpentry messed up my electrical system. He was not amused.

so sorry to hear that gina. >>neuropraxia of the lateral femoral cutaneous nerve has been reported in as high as 60% of cases with the anterior approach

i found that on another web site regarding nerves and anterior approach.

then in the next paragraph it says...The internervous technique is one of the major advantages of the anterior approach. The sciatic and femoral nerves are well outside of the operative field, and there is less of a possibility of injury to the nerve supply for any of the major muscle groups of the hip joint. With an “oblique” skin incision, in line with the long axis of the femoral neck, injury to any major branches of the lateral femoral cutaneous nerve have been extremely rare in our experiences.

as you can see VERY VERY CONFUSING and inconclusive. one minute nerve damage is almost certain, then next minute hardly ever happens... all of this makes my head spin

I agree, very confusing. Like I said as a home health nurse I have taken care of patients of this surgeon and even though I don't know the exact number, I know there were many that had the anterior and only need a short term home physical therapy, mostly just to make sure they were safe at home. So with this info and the info I researched I went with the anterior, safe in my mind that it was the best approach for me. So when I found out that my sciatic nerve had been stretched during surgery causing the back of my leg down to the bottom of my foot and toes to be dumb, we were all confused. It took 2 regular MRI's to rule out back problems and finally the special MRI neurography which showed the stretch to be at the surgical site.

That is interesting. There have been quite a few people on this board with anterior approach who have complained about sciatica afterwards. I had posterior approach and I noticed on my surgeon's notes that he had mentioned protection of sciatic nerve whatever that meant.