Yeah, I have this sneaking suspicion that because he’s always done it this way and it seems to be working well for him (he gets phenomenally positive reviews, both on line and from a couple of people I’ve spoken with who have used him for their hip replacements) he figures why bother to change. And maybe those are good reasons for HIM to keep doing posterior surgeries.
From what I read on line, the local MDs who do anterior approach have very long waiting lists, so it seems to be much in demand.
Our modern era has lots of info available to patients. Decent bet collective patient preference for [whatever] can shift faster than the medical establishment in general, or any given provider in specific, can shift provision to meet that demand.
It’s good that nowadays patients have access to lots of info. As long as it’s good info of course. e.g. one can quickly google up a library’s-worth of anti-vax nonsense. That’s bad.
Note I’m not suggesting the knee replacement anterior / posterior choice is based on bogus info. I know I don’t know and am happy to take everyone here’s word for it. My main point is that if anterior is actually superior for almost all cases, we’ll all learn about it faster than the medical establishment can switch to providing it for almost all cases.
UPDATE: Surgery scheduled for Aug 21, with a surgeon who does anterior approach using the Hana split table. According to the documents the hospital (UCDMC) handed me, they give you a walker at the door and you walk out under your own power, usually the same day. Wow.
In retrospect, I should have had this done about a year ago. Since I started noticing things going downhill in Jan, my hip has been getting worse fast. I’ll be glad when it’s over.
My wife is currently two weeks of recuperating from a repair of a repair of her right hip. Crutches and hip brace six weeks.
She has a hypermobility condition, Ehlers Danlos Syndrome, so she’s had many other joint surgeries… TMJ, C spine, shoulder, both hips before, ankle …
The repair had been fine until she was T boned in a car accident last year. Tore the repaired labrum.
Not sure why the surgeon, who just does hips, advised a re repair over replacement, and repair of a repair is a bigger deal than repair, but he was firm that it was the way to go. Cadaver labrum, shaping things up, removing bone spurs, capsule plication…
I first had trouble with my hip a little over a year ago; I went to an orthopedist, they did x-rays, and told me (and showed me the x-rays) that the right hip had arthritis problems. I was given PT and went on my merry way. About 6 months ago it started getting worse, and it has rapidly devolved into me limping all the time, and having a lot of difficulty going up and especially down stairs. Finally I got sick of that, and yesterday I saw the orthopedist again. New x-rays show that the arthritis has gotten worse, such that there is no visible space between the ball and the socket. I have been referred to a surgeon, and I have an appointment for Thursday morning to explore possibilities for a hip replacement.
I welcome any suggestions for things I should ask in this initial interview. I know about the anterior vs. posterior approach (my orthopedist also discussed that, but I read it first here). Anything else?
Yes, that sure sounds familiar. The other question you are supposed to ask is “how many of these have you done?” I also scanned all the on-line reviews I could find.
Did you have an infusion afterwards? If so, you would have had an epidural (yes, the same epidural that’s used in labor).
Local or regional anesthesia is used whenever possible, because it lessens the amount of general anesthetic that needs to be given.
I was given an epidural before. And I think also propofal. I donno what an infusion is.
It was kind of a mess, the surgery started 4 hours late. I really felt sorry for my wife having to wait and wait. They drugged me up pretty good though.
Then we had to drive home 50 miles over the continetal divide in a blizzard. We are/where mountain folk so not unusuall, but bad timing. Fun day.
Yeah, they want you moving immediately. Same for knees. The post-op therapist who came to our apartment for the first couple of weeks was pretty merciless.
Had both of mine done, first was done 4 years ago and the second 3 years ago. Anterior approach. It had gotten to the point that I couldn’t carry a backpack for hours, but the kicker was that this side-sleeper couldn’t sleep on his side any more.
Read an article a few months back on “what they don’t tell you about a hip replacement”. It would be worth reading if you are considering a hip replacement. One thing the article did not cover was permanent damage to the muscle in front of the hip joint caused by the anterior approach during hip replacement. I used to be able to walk all day (with short breaks). Now, 4 miles is the absolute most I can do. That muscle in front of the hip starts to get an intense burning sensation.
Do a search on that quote and you get dozens of blogs and articles of hugely varying quality and points of view, including one from a doctor with an axe to grind who says this (not going to link to it, because it smells bogus to me):
I have prevented thousands of people from getting hip replacements based purely on diagnostic testing. I’ve also treated thousands who had the surgery and continued to experience the same pain afterward. In both situations, I’ve found that the tissue in distress was muscle, and by treating the muscles, ultimately these individuals could resolve their symptoms and return to full functional capacity.
Most of the links one finds from this search cover points that are all covered in this thread, although with a wider span of experiences covered and accounted for. Not everyone recovers in 60 days, and there are apparently a few permanent limits to hip-related movements that need to be observed (the most common observation is to debunk the idea that the new hip is bionically better then the natural original).
I think anyone who was walking miles and miles in a day without serious fatigue is in a different category from 99.9% of the rest of us. As for sleeping on your side, what I read seemed to indicate this was temporary, during recovery (and there are already nights when I can’t sleep on my bad side). But that is a question I will be asking.
If you woke up with a needle or catheter in your back, you had an epidural. That’s used for longer-term pain relief than just a spinal, which is intended to last an hour or two.
There may be some misunderstanding here. My discomfort when sleeping on my side was before the operation and was why I decided the operation was necessary. Two or three weeks post-operation that problem was gone.
Good choice, and best of luck. I posted here about my son having hip replacement surgery at a relatively young age, and it was the anterior approach, which as you indicated is less invasive and leads to faster recovery than the posterior method.
It’s the same as an IV-needle into a vein, drugs given through the thin little needle (or soft catheter). Often diluted in IV fluid run through a pump that delivers a set number of ml per minute. For surgery said drugs are often used to induce sleep/amnesia throughout the procedure.
This is the fastest I have ever seen Doctors’ offices move. I called for an appt. to my orthopedist last week; she saw me on Monday of this week, and referred me to a surgeon for my hip. I called the surgeon’s office Monday afternoon, and got an appt. for this morning. Now the surgery is scheduled for September 16th.
The surgeon confirmed that the latest x-ray shows apparent bone-on-bone abrasion, so there was no talk about more conservative approaches. Before they saw the x-ray, they were a little surprised by my limp, which is pronounced.
My anesthesia will be a spinal, plus something to make me sleep (so far unspecified; I hope it’s something like propofol, which I tolerate very well). I might need to stay overnight, depending on the time of day of the operation (not set yet) and the judgment of a physical therapist on the spot.
I am relieved at the prospect of this pain ending, and the ability to put on socks again.
A followup question, for anyone with personal or observed experience, about the post-op pain. How bad is the recovery pain likely to be, and how long does it last (until one is able to start building up muscle strength again)? Of course, everyone’s MMV, but any data points are welcome.