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Second hip replacement/anterior v posterior

Posted , 6 users are following.

Jayive
Jayive

Hi

I am due to have my left hip replaced and have asked my surgeon for anterior. He is not keen but instead is offering me the anterolateral approach but he says he would prefer to do it posterior. I do not want posterior as I still have problems with my right hip which are ongoing and I do not know what anterolateral is.

​I have resisted undergoing the left for 4 years but now the pain is so unbearable that I have no choice.

​Has anyone had both anterior and posterior and if so how did you find it. And has anyone had anterolateral?

​Thanks, Jay

0 likes, 13 replies

13 Replies

  • RichardKen
    RichardKen Jayive

    Posted

    Dear Jay

    I'm sorry that you had problems the first time around.   In what way do you believe that the posterior approach was responsible for your poor outcome?

    Cheers, Richard

     

    • Jayive
      Jayive RichardKen

      Posted

      Hi RichardKen

      ?I have had over 4 years of continual pain due to nerve damage and I can't go through that with the second one. 

      Thanks, Jay

    • RichardKen
      RichardKen Jayive

      Posted

      Dear Jay

      From what you have written briefly it seems that you believe that you are assured an outcome having your hip replacement with an anterior approach to avoid nerve damage. From all reports here it seems that people choosing the anterior approach are more likely to suffer nerve damage than with posterior approach. At the end of the day your choice of surgeon is likely to be the most important factor in having a good outcome.

      Good luck with whatever approach you go with.

      Cheers Richard

  • ptolemy
    ptolemy Jayive

    Posted

    Why do you think the anterior approach will be better?  I had a lateral posterior approach and had no restrictions after, although I did not discover this until four weeks later! I did not want an anterior approach as I understood there was more likelihood of nerve damage. My scar was really thin like a scratch from a rose thorn, I did not seem to have any swelling although that may have been luck. Surgeons tend to have preferred approaches so if you really want an anterior approach go for someone who tends to do those and is happy with them.
    • Jayive
      Jayive ptolemy

      Posted

      Thanks Ptolemy

      ​Your reply is most welcome as I have to see the surgeon again for further discussions before the operation.

      My first THR was posterior, with a 9 inch scar which took over 6 weeks to heal and now looks like a battle scar, very different from what you describe. The surgeon who I am with was recommended and happy to discuss the various methods. he says the anterior does not show any significant benefit and wants to do the posterior, I will not have this as I cannot cope with any more pain. he has offered an anterolateral approach and I now have to decide if I should have that.

      It is good to hear from other hippies their experiences.

      Thanks jay

    • ptolemy
      ptolemy Jayive

      Posted

      Hi Jay, it will be interesting to know how the two compare if you have the anterior approach. 
  • erin1956
    erin1956 Jayive

    Posted

    Jayive:

    I have had both hips replaced in the last 12 months. Both were anterior approaches. The anterior approach requires greater surgical skill, experience at doing that particular procedure as well as specialized equipment. If your surgeon is "not keen" doing that surgical approach to the hip joint, then let him do the procedure he is best at and most comfortable with performing. However, both lateral and posterior require cutting muscles which increase the rehab time and may add restrictions. I sought out a surgeon who does nothing but anterior THRs. I have had great results, no restrictions and a very good and quick healing/recovery. I am 51/2 weeks now and am moving up to light workouts at the gym. I'm back walking the dog with no pain. As others have commented, you can also have a very good outcome from either of the 2 other approaches.It was a personal choice for me.

    Whatever you choose, your quality of life will be much better than where you are today.

    • Jayive
      Jayive erin1956

      Posted

      Hi Erin

      ​Thanks for your response. How did you find a surgeon who did anterior? I had asked and went to the one who was recommended but he says he prefers to do posterior and I will not have that again.

      If you have anterior I understand that muscles and nerves are just moved and not cut. Is that correct?

      Cheers, jay

    • RichardKen
      RichardKen Jayive

      Posted

      Dear Jay

      I responded to you a few minutes ago but for some strange reason my reply is awaiting moderation.

      In all the months I have been here the hip surgeries where nerve damage has been an issue have generally been with the anterior approach.

      There are several good reasons why the posterior approach is less likely to have issues but of course all surgery comes with a risk as does not having surgery when it is needed.

      Cheers Richard

  • maureen24786
    maureen24786 Jayive

    Posted

    Hi Jay...After struggling for a long time to get the courage to do the THR I went for the anterior approach. I am 8 weeks post surgery & struggling with nerve issues. My knee & shin are numb & my.leg feels wooden & unresponsive. I am beginning to be deeply depressed about this. Others have had very successful results with the anterior approach. Personally I wouldn't do it this way again. I go back to see the surgeon tomorrow so not sure what is next. Good luck. Maureen

    • RichardKen
      RichardKen maureen24786

      Posted

      Dear Maureen

      I really do hope that your surgeon will have worked out a plan of action for you. I really cannot imagine how tough it must be to be having to cope with nerve issue this long after your surgery.

      Best of luck, Richard

    • Jayive
      Jayive maureen24786

      Posted

      Hi Maureen,

      ?Please see my reply to Erin as I understood there was no nerve damage with anterior.

      ?From my first posterior THR my leg still feels wooden and numb and my hip is in continual pain and that's after over 4 years.

      I do hope you feel better after you see your surgeon, do keep in touch.

      Cheers Jay

    • maureen24786
      maureen24786 Jayive

      Posted

      Hi Jay - the single biggest risk with the anterior approach is damage to the femoral nerve. I see the surgeon yesterday & was sent for extensive EMG

      Not particularly painful but a bit arduous. Doctor puts needles all up and down leg - front, back sides from groin to toe & back again. Repeating again where there seems to be an issue. Then same thing with a sort of TENS unit. Then they do the good leg for comparison. Very tedious but thorough. Turns out I do have moderate nerve damage but it doesn't affect the muscles. I need to take cortisone otally for a month & must push thru this feeling to continue to strengthen the muscles. It's a bit depressing but not I guess terrible. Unless you choose a surgeon who is very experienced with the anterior approach (has done at least 100 or more, I definitely do not recommend it. Mine was very experienced & yet still had this issue. My neighbor had the lateral approach & has done very well. I was strongly encouraged to do nerve stimulation treatment - which I will do but no idea yet what this entails. Good luck with your choice. Maureen

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