Posted , 9 users are following.
Have any of you watched a video of a hip replacement? I just watched the anterior approach. It’s amazing what they can do through such a small incision.
Also makes me ask how can they remove and replace with such a small area?
0 likes, 24 replies
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monkeypearl Dsilk05
Posted
Hi, guess it was a video nasty lol
Sorry I have little knowledge of this at the moment. I'm sure some fine hippies will be around soon 😀
Stay safe
Pete
Dsilk05 monkeypearl
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RichardKen Dsilk05
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Dear Dsilk
Yes I've watched several and am not surprised that there are more problems following an anterior rather than the posterior approach. It must be quite a bit more difficult to see what they are doing and it strikes me that with so little room there is going to be much more pulling of muscles and tendons. Also there are real difficulties when a normal or longer stem is needed so the surgery is likely to be compromised. I would go for the posterior approach every time thanks<BG>
Cheers
Richard
Dsilk05 RichardKen
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RichardKen Dsilk05
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Dear Dsilk
I rather doubt that claim going on my own experience<G> Ony needed one walking stick when I left hospital, tossed that i a day or so, was walking very rough country tracks almost on day one once home with the dogs, quickly extended it to a mile or two each day and back to work in just over a week doing the sheep feeding which involved handling bales of hay and general office work. Cannot see what more I could have managed with an anterior approach to be honest.
I was not given any exercises to do or had any physio not given any restrictions just told to take care that I did not twist the leg as it was not cemented. I think that it was perhaps as good as it gets and of course we are all very different. I do not recall having any pain or taking pain meds after leaving hospital.
Cheers, Richard
Rocketman_SG6UK Dsilk05
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The largest part (apart from the stem which is long and thin), is the acaetabular shell. Mine is 58mm (2.28 inches) across, so I'd have needed a minimum 58mm incision.
RichardKen Rocketman_SG6UK
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But this item is quite thin unlike getting a long stem in place, and of course the stem is likely to be trial fitted several times until the fit is correct so adequate space must be quite an issue.
Cheers
Richard
Rocketman_SG6UK RichardKen
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Agreed.
Not an easy job, but then that's why it takes so long to train a surgeon.
I'd rather have posterior approach too - there seems to be better access, and I hear so many horror stories of groin pains with anterior.
I just wish my surgeon had taken more care in fitting my ceramic insert squarely in the shell.
Graham
jimbone Dsilk05
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Dsilk05,
I haven't watched the video of the anterior or any other surgical approaches yet. Still trying to gather the stomach to look at what they're going to do but I would point out regarding your question of how they can move and replace in such a small area- that is one of he reasons why some surgeons reject this approach, When I first heard of the anterior approach and looked into it I was hopeful it provided a hedge for a better outcome. After further research my decision was to consider alternatives. You can google "Why I no longer do the anterior approach". It brings you to a website for a surgeon in FLA that is very informative and had insurance allowed for coverage outside my home state of WA I would have been willing to travel for the operation under his care. One point he does make repeatedly is that it is the skill of the surgeon not the approach that is most critical but his objection to the Anterior approach is just the same as you point out: insufficient room especially in placing the stem of the prosthesis. If you look up Dr. Hedley in AZ, there is an informative video why he does not use the approach as well. I don't want to dissuade you from your choice. Many people I've read about here have had very successful outcomes with that approach, some have difficulties especially with damage to the femoral nerve. There is a surgeon near me who uses the direct superior approach, another tissue saving surgery that I have high confidence in, but the bottom line is the confidence you have [based on as much research and information, results, experience, number of revisions and professional standing you can locate] on the surgeon themselves. I know part of my research is really just magical thinking- looking for a miracle cure and a risk free surgery. It's hard to reconcile that with reality as I know it. It's major surgery and there are risks that need to be accepted which is a hard pill for me to swallow. The best I can do is to learn as much as I can about those risks and take every step to minimize them. I've read advice that seeking a second or even a third opinion, preferably from surgeons that share a practice is a good way to get objective information. It might be good advice. With all that said, there is a dance instructor here on the forum who has had bilateral replacement with the anterior and was back teaching classes within 4 months if I am not mistaken as well as other successes. Wishing you the best.
JImbone
jimbone
Posted
Correction: seeking advice from surgeons that do NOT share a practice. I just signed up for my 2018 insurance. Come Jan. I make an appointment with the orthopedic surgeons. Meantime, I'm in the gym/pool to prepare to be in top physical condition about every day.
Dsilk05 jimbone
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I had confidence in my doctor, as I researched him and others as well, and agreed with his approach.
We all heal differently too. So we just never know.
jimbone Dsilk05
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Dsilk,
I see that you've already had the surgery and it seems like things are working themselves out. Glad to hear that and hope your recovery goes well. Stay stong.
Jim
Dsilk05 jimbone
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michael11283 Dsilk05
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Dsilk
Yes I think the video of the surgery shows how difficult the surgery is and how a capable surgeon makes it look easy.
I've never worried about the size of my scar though. The one for my revision is about 18 inches I think.
Mike
RichardKen michael11283
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That is a surprisingly long scar! Both my primary and the recent revision resulted in a scar or about 8 or 9 inches and both were done posterior. Healing of the scar was pretty rapid with little to be seen after six months.
Cheers Richard
michael11283 RichardKen
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Yes it is long but fading now after 5 months. He cut away some of my femur that had been damaged by the infection so I have a long stem and I think the washing out process to get rid of any infected tissue means he exposed more than needed just to replace the joint.
Cheers Mike
RichardKen michael11283
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Dear Michael
Thanks for explaining why the length of your incision. I'm glad that you are doing OK.
Cheers Richard
claudia95892 michael11283
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michael11283 claudia95892
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Hi Claudia
Sounds like you've had quite a journey with your hips. Mine was fairly straightforward. I'm not sure how long the rod is. When they x-ray it they do in in two pictures. But I don't have any rings around it.
Recovery is a bit slow but I am gradually making progress. I'm hopeful that by the spring I'll be back to normal.
Off to Chamonix for Christmas (my daughter lives there) but I won't be skiing this year.
Mike
claudia95892 michael11283
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judith12644 michael11283
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