Posted , 17 users are following.
Hi, I'm having my THR next Tuesday and have just found out its the posterior approach (I was hoping for anterior) and it seems more difficult to recover from what I read. Any hippies out there who've had this offer any advice? Would rather hear from people that have had it done rather than articles. How long was stay in hospital? Thanks all!!
1 like, 29 replies
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Chris8968 kirsty41826
Posted
Hi Kirsty
I've had the posterior approach on both hips 6 months apart. I was in the hospital for 5 days, on a walker for 4 weeks and a cane for 2 weeks after that. There seems to be less that can go wrong with a posterior, the only drawback is a longer recovery period but long term results are more important. My surgeon wouldn't even do the anterior approach.
grace8617 kirsty41826
Posted
Hi Kristy,
I know it's a scary thought of having this surgery. It's not really as bad as you are anticipating. I would try not to worry because your doctor will give you pain medication until you are up and on your feet. My hospital stay was 5 days. Everyone in the hospital was great. I also had visiting nurses come to my house as well as physical therapists. They were all wonderful! My problem was falling down the stairs. Just do what they tell you to do and you will be just fine. No matter how they do the surgery, it has to be done. They have gone to school for this type of surgery so they know what they are doing. You will be fine. Best of luck and please let us know how you're doing. You're going to be fine!!!😊
renee01952 kirsty41826
Posted
hi kristy,
my experience is the same as Chris41840 -
2 THR surgeries 6 months apart and both posterior -
I don't know if you have a choice and perhaps find a surgeon who is experienced in anterior THR -
It also depends if you are a good candidate for anterior -
usually when you had posterior approach with 1st THR, the same approach is used for the 2nd one (should you need one) - however, I do remember a post from a member here who had one done with posterior and the other anterior ..
I was full weight bearing after surgery, walked with physical Therapist the next morning - I live alone and preferred to stay one day longer -
Not sure what more to tell you - Please come back here and keep us posted -
you are not alone anymore -
big warm hug
renee
maggie93798 kirsty41826
Posted
kimberley38758 kirsty41826
Posted
Hi Kirsty,
I had a FRHR (Posterior Approach) 8 months ago. My experience was very positive. I was out of the bed walking with the aid of a walker within 2-3 hours after the surgery, and went home the next day. By my 10 day post op appointment, I was walking without the use of any aids. I started physical therapy the second week and continued for 8 weeks. At that time my hip, lower back and leg was stable and I no longer limped. By week 9 I was back to work full time. I've continued to do very well.
Wishing you the best
samantha_2158 kirsty41826
Posted
Hi Kirsty,
I am five weeks post left hip replacement posterior. My surgeon chose to do posterior for better view of joint and I went with his recommendation.
It has been a great recovery (as they go!) - scar is only 4", swelling has gone (only swollen on hip), was on one crutch after two weeks and am now on no crutches. Showering day 2. In hospital 2 days only. Am driving now (automatic) shirt distances.
90 degree restrictions for 6 weeks but these have been easy to follow.
It has been a miraculous surgery for me as i was bone on bone pre op.
Don't worry too much about the approach. More important is your surgeons experience and his recommendation as to what's best for you.
Good luck!
Sam
TLHR 20/2/27 posterior
gloriajoy kirsty41826
Posted
Hi Kirsty
I was of the same opinion as you and researched to find a surgeon in UK who would do the Anterior approach.
However I finally concluded that the experience of the surgeon was more important and their own preferred approach.Also the Anterior is not suitable for all patients.
After more than 2 years of researching I finally had my THR by the Posterior approach.
I can only report that everything has gone extremely well.No nasties at all.off pain killers by 3 weeks. A very neat small scar and I was walking well by 4 weeks. I did not need a walking stick,but always took one along more from fear of falling over on uneven surfaces or being jostled in crowds.
Have just returned from one month in Mallorca, and while there I didn't use a stick at all.Went for regular walks,did all my shopping,despite my location where access was via over 100 steps to my door.
I am 80 yrs live and travel alone.
From my experience,fear of the operation was much worse than the event itself.
Good luck and don't worry!
Joy
gloria81144 gloriajoy
Posted
Good for you! Gave me great hope! I'm 73, bone on bone tomorrow is my day! Again so glad you are doing well!
judith12644 gloriajoy
Posted
judith12644 gloria81144
Posted
gloriajoy gloria81144
Posted
Dear Gloria
Wishing you the very best outcome and good luck for tomorrow!!
The thing I found was that the essential routine after the op. of exercise/rest/walk/rest/eat/walk/rest,(don't forget to rest) meant that time passed without noticing it.
Before you know it,it is all behind you. Just follow the advise,do the exercises.Rest when tired and concentrate on your own well being,and
before you know it, it is all over.
Joy x
renee01952 gloriajoy
Posted
so good to see you here again and to read how well you are doing !!!!
seriously ...you did a lot of research and very thorough at that -
great that you are travelling again -
big warm hug
renee
steve86482 kirsty41826
Posted
erin1956 kirsty41826
Posted
Kristy:
Please, rather than hope, you can seek an orthopedic surgeon who specializes in the direct anterior appraoch. I did a lot of reaearch and came to the conclusion that the anterior appraoch was the only way I would have THR. it was the very correct choice.
I am 4 1/2 months post op now. I feel great and have resumed my cross training routine and will be back to riding my bike as the weather turns nicer. I had THR as an out patient procedure i.e. I didn't spend any time in the hospital. The worse "complication" I had was a hematoma that went awy after a few weeks.
The posteior approach will cut through your gluteus maximus. The anterior approach does not cut any muscles: a huge difference from a recovery timeline perspective and additonal complications.
OS who specialize in the anterior approach are far and few between. It takes specialized equipment and has a far better outcome with less complications. That's because it takes more skill and experience than the lateral or posterior approach. Most OS don't have patience or skills to master the anterior approach hence they choose/go back to what is easier for them but not the patient.
I hope the very best outcome for you, of course. The best advice I was given is that less is more immediately after surgery. Let your wound heal properly. I didnt start PT until 7-8 weeks post op. Many complications arise from pushing it too much too early.
Take care,
samantha_2158 erin1956
Posted
Sam
erin1956 samantha_2158
Posted
Below are examples of how the surgical steps of an anterior approach hip replacement differ from the steps of the posterior approach, which is the most commonly utilized approach to hip replacement in the US.Location of incision
During anterior hip replacement the incision is made at the front of the hip. This incision starts at the top of the pelvic bone (iliac crest) and extends down toward the top of the thigh.
During posterior hip replacement the surgeon makes a curved incision on the side of the hip, just behind the greater trochanter, the knobby bit of bone that sticks out at the side from the top of the femur (thigh bone).Muscles affected During anterior hip replacement the surgeon works between the muscles, with minimal or no muscle cutting. Utilizing this interval between the muscles is called the Hueter approach, after a German surgeon who first described this method of entering the hip joint. It is a truly “internervous” approach, meaning the surgeon is working in between muscles supplied by different nerves, so it’s a natural separation that allows ready access to the hip joint.
The traditional hip replacement approach requires surgeons to cut muscles and other soft tissue at the back of the hip to access the hip joint. First, the surgeon cuts the fascia lata, a wide piece of fibrous soft tissue at the top of the outer thigh, and the large gluteus maximus muscle that attaches to it. Next, the surgeon must cut the external rotators of the hip, which are small, short muscles that connect the top of the femur to the pelvis. These muscles provide hip stability, preventing the femur from dislocating out the back of the hip socket (posterior dislocation). These muscles are repaired and reattached at the end of the surgery.
Technical ease of surgery
A surgeon tends to have a limited view of the hip joint during anterior hip replacement surgery, making the surgery technically challenging, especially for less experienced surgeons.
A surgeon tends to have a good view of the hip joint and comfortable access to the hip joint during posterior hip replacement.
All hip replacements require the opening of the hip capsule and shaping the bones in order to implant prosthetic hip joint components.
kimberley38758 samantha_2158
Posted
I had the Posterior Approach and mine weren't cut either. As Sam stated, they were moved to the side. Very quick recovery.
kimberley38758 erin1956
Posted
Hi Erin,
There are Pros and Cons to each approach. The best things to do is find a surgeon who has a great deal of experience on whatever type of approach they use. If you read the many posts on this forum, you will see that a particular approach didn't necessarily determine the outcome or how quickly the patient recovers. You can't believe everything you read on the internet, as many articles are not factual. That's why I love this forum. The posts are from people who talk about their real experiences.
rose73925 kimberley38758
Posted
Same here. Don't think anything was cut because I got back lifting/squeezing functions so quickly. Certainly within a few days of surgery. There is obviously something to be said for each type, but my instinct, like others here is to meet your surgeon, check his credentials, then go with what he is used to doing - practise being the keyword. I preferred to have someone who said openly "I like this operation" !
samantha_2158 erin1956
Posted
They don't do all posterior this way any longer. I had what he called a minimally invasive posterior. Muscles pushed to the side. Small 4" straight scar. Very quick recovery. No walking aid of any kind at 4 weeks.
I think it's easy to get hung up on types of approach. I think more important is the surgeon's track record and what they suggest for the individual. Just my opinion.
Sam
beth2509 samantha_2158
Posted
I agree - I had minimally invasive fiv e months ago. Walking within hours, our of hospital the next day, no pain, and the hip has never looked back. No muscle was cut.. And we have had people on this forum who have had a nightmare recovery from anterior. The type of surgery isn't an indicator of how hard or easy it will be on you. There are too many factors to predict. But most people do really well from a hip replacement, regardless of technique.
erin1956 samantha_2158
Posted
I stand corrected. Everthting I read from credible medical websites does not mention this newer technique that precludes muscle cuts to get to the joint in the posterior or lateral position.
I do agree that any surgery sucess relies mostly on the skill of your surgeon.
But, this is good to know and hope the best and a speedy recovery!
kimberley38758 erin1956
Posted
Erin / Sam,
I go for my 8 month check up tomorrow morning. I'll find out more about the cutting. It sounds as though there may have been some, but don't have the details yet about mine (posterior). I'll let you know what he says
Either way, my experience was very positive and a quick recovery.
kimberley38758
Posted
I stand corrected. According to my surgeon I did not have do the posterior approach on me like I thought from looking up procedures on the internet. My muscles were not cut because he used the Antero-Lateral approach.
Anterolateral Total Hip Replacement
A minimally-invasive procedure, anterolateral total hip replacement is performed through a small incision on the anterior, or side, of the hip. Because muscles and tendons are not disturbed, the prosthetic joint is more likely to remain in place during the recovery process. Patients who have had anterolateral hip replacement do not have the same movement restrictions as those who have had a posterior total hip replacement. This procedure typically results in less pain, quicker recovery and faster return to everyday activities.