Super path or minimal invasion op in the uk
Posted , 14 users are following.
**morning. This time last year due to the NHS crisis last winter i had my hip replacement cancelled and for various personal reasons was unable to have it done at all last year.
unfortunately my hip has got so much worse this year and my mother in law has very kindly offered to pay privately and has suggested the new minimal invasion surgery as i was a dancer and would very much like to be able to continue to some lower level. . does anyone have experience of this op and anywhere they could recommend for the op?
thanks
0 likes, 68 replies
erin1956 heather78265
Posted
Hi Heather:
I've had 2 hip replacements both anterior and minimally invasive. The worse issue was loosing surface skin sensations/feelings on my left thigh which have now healed and back to normal. On the right, I had a hematoma which is swelling due to fluids escaping from the internal incision area.
Other than those two issues I am extremely happy with the outcome. The comment that it is the skill of the surgeon is very valid and most important. The anterior approach is more difficult technically (carefully moving muscles, tendons and nerves with no cutting) and you want to look for a surgeon who specializes in this technique. That's why most hip replacements are posterior approach: less technically challenging and surgeons do not master the more difficult method.
Post op, you must be vigilant with your physical therapy routine. Stretching is important for a long term, successful recovery to help make sure ligaments extending from the hip down the leg are stretched properly to avoid lower back pain.
Today I am fully recovered, riding a bike and working out regularly at the gym. Life is of a much better quality. I am pain-free.
I hope your surgery goes well. You also want the best possible outcome and I am convinced, through my experience, that the anterior method is the way to go..
belinda90268 erin1956
Posted
I've had two posterior Superpath hip replacements and they use the method of moving ligaments etc and no cutting with that. It is a very specialised method but it is done posteriorly.
Doodle56 heather78265
Posted
i had private surgery 3 years ago and it was very successful .
i chose the surgeon carefully and everything went to plan.
i a having other hip replaced ne xt week by the sa me surgeon at the same p,ace but on the nhs .
whereab outs are you based ?
i think that the most important factor is the surgeon an d your confidence in them .
i hope all goes well
heather78265 Doodle56
Posted
buckinghamshire
judith12644 heather78265
Posted
Hi Heather, I live in North London, and had minimally invasive surgery on my right hip a few years ago. I would thoroughly recommend my surgeon, who is very experienced. I saw him at the Whittington Hospital as an NHS patient, but he also does private work at several London hospitals. I was lucky, saw him in June 2016, he just got out his diary and we fixed up a date for a month later. I had the pre op the same day. I had a very straight forward recovery and I do all the things that I used to do, except for distance running.
heather78265 judith12644
Posted
thankyou i would appreciate his name
judith12644 heather78265
Posted
Hi Heather, he is called William Bartlett. There's plenty about him on line. On his total joint website there are little clips of his patients after their ops.
At the Whittington hospital, where he works for the NHS, he leads the enhanced recovery programme, where you're up on your feet just a few hours post op. I would imagine it's the same with his private work.
heather78265
Posted
thankyou
john26284 heather78265
Posted
Hi Heather, I am 65 years of age and 11 days post op from a minimal invasive THR and have so far been amazed at how good recovery and lack of pain in general there has been. My scar is just 3 inches and was glues closed and is so neat its untrue. I am already able to walk 300 yards plus with just one crutch and already can see this will change my life. I was recommended a surgeon Mr Hugh Apthorp at The Spire in Sussex though he also practices at other hospitals in Kent and London, I am so pleased I had this recommendation.
Doodle56 john26284
Posted
i am having hugh apthorpe replace my hip on Tuesday.
he replaced my other hip 3 years ago and did an excellent job with just a small wound and quick recovery .
so good to hear your great progress John
john26284 Doodle56
Posted
Hi Doodle, Good luck with that but you dont need me to tell you what a superb surgeon you will have. I have been so lucky to have had him recommended.
heather78265 john26284
Posted
thankyou thats good news to hear
robert88575 heather78265
Posted
Heather, just be careful about thinking SuperPath is some magic.
Surgeons are operating more than ever on people in their 40s, 50s and 60s. And lots of "younger" patients (like me) don't just want to walk around the block after surgery. They want to return to activity, aggressive exercise activity. And the best surgeons (regardless of their approach) are on board with this.
I got the surgery precisely because I couldn't dance (my hobby is Swing and Lindy Hop) without pain. I wanted to dance (for hours!) without pain and be able to run again without pain. My surgeonl was totally confident about me returning to dance.
All the approaches (even the traditional posterior) cut less and get people on their feet faster than ten years ago, 15 years ago. SuperPath like any other approach has a serious learning curve, perhaps a greater learning curve because the surgeon has a limited, less clear view of what they're doing than in say, the posterior approach.
Just an example: there is a surgeon here in the States (in New York City) that I would have loved to have gone to for my surgery. But he didn't take my insurance--he's sorta the surgeon to the stars, as they say. He uses the traditional posterior approach and he developed all these breakthroughs in sewing up the soft tissue so that hips could withstand a lot more force without problems. He's had patients who've been running or playing basketball for years! With fast recoveries no less. Why? Because he is a master surgeon, not because he used any particularly new approach.
Find the best surgeon ... tell them about your goals ... find someone highly skilled who is confident of you reaching those goals ... and you're far more likely to get an excellent result than focusing on an approach. The approach is merely an outline of how the surgeon does the cutting ... It's skill and experience that allow surgeons to really fine tune their approach and tweak it to fit their own skills. Find someone who does at least 200 + surgeries a year. The best ones often do 300 a year. And if you choose someone doing Anterior or SuperPath, you want them to have used this approach for at least 2+ years ... It takes that long (at least!) for surgeons to get "comfortable" with a new approach. "Comfortable" = confident they can cut in a way that places the device well and gets the best results for their patients.
Since you seem really intense about dancing, I'd say you want someone who has done at least 1,000 surgeries with their current approach. All approaches have danger spots and nerves that surgeons must avoid. Never use a surgeon who is only starting with this new approach.
Good luck.
RichardKen robert88575
Posted
Dear Robert
I understand the wish to carry on running etc but regardless of the procedure I think the it is only wise to be aware that the impact on the joint will result in greater wear and more significant is the greater the possibility of the stem loosening which would require a difficult revision with its attendant risks.
Cheers Richard
ps My first total hip replacement gave me twenty years of hard service and I hope my recent revision will do as well.
heather78265 robert88575
Posted
thankyou that is sound advice! yes ive never not danced. its been my whole lifes work!
robert88575 RichardKen
Posted
Hi Richard,
I actually spent a lot of time talking to surgeons about running and researching the topic. And I admit: I was surprised to learn that a lot of the best surgeons no longer think running will prematurely wear down the joint.
This change was brought about by the new materials ... namely the ceramic heads and the cross-linked polyethylene liners on the acetabular cup. (Your initial hip was most likely the older polyethylene ... and not a ceramic head.) But the cross-linked polyethylene dramatically reduced wear rates ... Then there was a second generation of cross-linked polyethylene liners and the wear rates were reduced dramatically again ...
Two top surgeons I consulted said that on hips done up to 12 and 14 years ago --with the new materials-- they can look at what's going on through radiographs ... ... and see if the liner is being worn or particles from the liner are going into bone ... and they're finding "almost no wear." Not quite zero wear ... and zero particles entering the bone, but almost zero ... in hips in place over a decade.
There were actually never any research studies that found running was harmful to hips in the first place. The surgeons who made that recommendation always admitted they were going on gut and intuition (which is not to be totally dismissed).
The closest surgeons could get to evaluating the impact of running or singles tennis and so on ... was by looking at the results of surgery on young people, patients under 50 ... who are presumed to be far more active than older patients. And yes, I think for a while younger people did have shorter-lasting hips than older folks--with the old polyethylene. Well, with the new materials studies started coming in finding that the new hips of people under 50 were lasting as long as the hips of older people. Activity level didn't change the wear rates.
BTW: the term surgeons use for allowing aggressive action isn't "running is OK." Their term is "no restrictions."
RichardKen robert88575
Posted
Thanks for your interesting reply. I don't think that you addressed the danger of loosening of the stem. I see this as the greatest danger of running or a sport such as squash or tennis. Cheers, Richard
ptolemy RichardKen
Posted
Last year there were a couple of British Commentators at the French Open both had been top class tennis players and they were raving on about replacement hips and how they were still playing tennis.
RichardKen ptolemy
Posted
I would be interested to hear of their progress in ten and twenty years time. How about Andy Murray. Did he actually have a hip replacement and if so can anyone provide details please.
cheers, Richard
robert88575 RichardKen
Posted
Hi Richard,
The stem usually loosens because over time wear particles from the head rubbing up against the cup fall into the bone around the device ... and ... these particles from the implant weaken the bone around the device ... leading to loosening.
That's why the breakthrough of ceramic low friction heads against extremely low-wear cross-linked polyethylene liners changed the game ... This combo has almost eliminated friction particles falling off into the bone around the hip. The long-time fear about running was that the impact would create more rubbing and wear and friction between the cup and the liner, leading to more particles falling off and getting into the bone around the joint. But so far that's not happening with the new materials.
At the bottom of the device, uncemented hips fuse with bone ... so they're rock solid ....
ptolemy RichardKen
Posted
No, he had his hip resurfaced in Australia by a surgeon called John O'Donnell. I believe it was keyhole surgery.
RichardKen robert88575
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Interesting fhanks. I was aware that osteolysis was one of the main reasons of the failure of hip replacement and other replacement surgeries. It was the reason my four year old total ankle replacement had to be completely redone last year....ouch. Oh yes at my six month check last week when I jokingly asked my surgeon when I could start running he said NO WAY!
Cheers, Richard
RichardKen ptolemy
Posted
Thanks. As that does nit seem to have done what he needed I wonder what his next move will be. Cheers Richard
ptolemy RichardKen
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The press seem to think he is going to try another resurface op.
RichardKen ptolemy
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Thanks, Richard
ptolemy RichardKen
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I saw an article in the press today saying Andy Murray should have stem cells for his hip!
RichardKen ptolemy
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Yes but I have yet to see any independently authenticated successful results where hips are concerned. Anyone know better?
Cheers
ptolemy RichardKen
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Sadly I think that is true for hips, although it seems quite a lot of progress is being made. Hopefully for my next hip replacement! I assume if you need a revision it will not work.
RichardKen ptolemy
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Quite so. Out of interest I checked on the cost of a private hip replacement and the cost of a revision and the revision was double the cost of a primary. Guys this must reflect the anticipated additional problems so I would urge everyone to look after their's. Cheers, Richard
ptolemy RichardKen
Posted
I think the robustness of the materials used has improved a lot over the years. I think round here places like Spire Health offer a total package for around £13,000 although a friend had her hip done at the London Bridge clinic and she paid over £20,000.