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This is helping me so much, all of you! I know he hates to think about surgery...who doesn't, but yes he uses a walker now and its not getting better. I will have to be the one to set an appointment, but that's ok. We kinda roll that way...long as I can get this going. And, like I said, his lack of mobility affects me as I want us to do things together. I just don't see me going off to places and he sits home using a walker? We will have our 50th anniversary in November and its my goal to get him fixed so we can go off on an epic trip! But he did rob the cradle as I was 19 and he was 24 when we married, lol.
I had a THR in November, 2014. I had pain in the front of my thigh for about 6 months and thought it was my bad back. I went to the top rated orthopedic group in the Charlotte, NC area and a top rated doc for replacement. Forced to wait about 6 months for my surgery due to his schedule (terrified the whole time) and had a posterior replacement. I am sad to say that during the surgery they damaged 2 major nerves and I spend 5 months on PT just to be able to walk with a walker. My leg would just collapse under me and twice I fell. The doc pretty much ignored me and I ended up with PAs for any visits until I went to the back doctor and complained and HE was the one who sent me for a nerve test and insisted that any follow-up visits would be with doctors only. Nerve test said the damage was temporary and would heal, but never did. We moved to DE the following April and hubby had to do all the packing.
Here it is over 4 years later and it's still not right. Yes, I can walk without a walker but I use a cane most of the time I am out. I have hip pain and unexplained tightness around my knee. Yet my neighbor had one and was up and walking within a couple days (and out of the hospital the next day). Just saying that you can do everything right and it still might not come out well.
I had a THR in November, 2014. I had pain in the front of my thigh for about 6 months and thought it was my bad back. I went to the top rated orthopedic group in the Charlotte, NC area and a top rated doc for replacement. Forced to wait about 6 months for my surgery due to his schedule (terrified the whole time) and had a posterior replacement. I am sad to say that during the surgery they damaged 2 major nerves and I spend 5 months on PT just to be able to walk with a walker. My leg would just collapse under me and twice I fell. The doc pretty much ignored me and I ended up with PAs for any visits until I went to the back doctor and complained and HE was the one who sent me for a nerve test and insisted that any follow-up visits would be with doctors only. Nerve test said the damage was temporary and would heal, but never did. We moved to DE the following April and hubby had to do all the packing.
Here it is over 4 years later and it's still not right. Yes, I can walk without a walker but I use a cane most of the time I am out. I have hip pain and unexplained tightness around my knee. Yet my neighbor had one and was up and walking within a couple days (and out of the hospital the next day). Just saying that you can do everything right and it still might not come out well.
Do you know why you had a posterior surgery (rather than anterior)?
OP, please don't let this dissuade you. As I stated earlier, there will always be a small percentage of surgeries (ANY surgery) that has an unintended outcome. Please visit https://bonesmart.org/hip-replacement-surgery/ for more information. They have a patient forum there that will blow your mind with information and real life outcomes.
My husband had avascular necrosis and had a grossly deteriorated hip at age 45. He attributes it to the bi-annual cortisone shots in that hip for severe allergies, but the cause isn't really relevant. He was on a cane and was in constant pain. The first ortho told him he wasn’t a candidate for THR because of his age and the fact that it would likely need to be replaced again in 15 years.
When we went for a second opinion, we told the ortho doc that being in pain and misery for another 15 years (the best 15 years of the rest of his life) wasn’t an option. He agreed to do the surgery and he was able to live a very happy pain free existence for the next 16 years before he had to have it replaced.
Quality of life is huge. Hip replacements have come a long way and a few weeks of inconvenience is well worth the many years of pain free existence post surgery.
More surgeons are opting to NOT do anterior since so many end up with nerve damage, I live with 8 yrs of horrid femoral nerve damage, IT band damage, shorter leg and trochanter bursitis. Nice gift I got from the anterior approach.
Newer is not necessary the best.
A surgeon in Louisiana has a site about the Pros and Cons of both.
My husband had his hip replaced a few years ago, posterior. He asked his doctor about anterior, and his doctor said, “well, I’ve always wanted to try one, so I will if you want”. He was joking, of course. I think the point is, whatever method your doctor has done, with good success, hundreds of times, is the kind that’s best.
Newer isn’t always best, as jaminhealth said. My ortho doctor does not use the latest and greatest knee replacement. He uses the one with a safe 20 year track record.
More surgeons are opting to NOT do anterior since so many end up with nerve damage, I live with 8 yrs of horrid femoral nerve damage, IT band damage, shorter leg and trochanter bursitis. Nice gift I got from the anterior approach.
Newer is not necessary the best.
A surgeon in Louisiana has a site about the Pros and Cons of both.
Femoral nerve damage is talked about a lot in this link. I'd be curious just how many end up with this damage.
It's rare. And it is not true at all that "More surgeons are opting to NOT do anterior since so many end up with nerve damage".
More surgeons are using anterior than before, because they are becoming TRAINED in the procedure. It is absolutely a more technically challenging procedure.
"The physical build of some patients increases the difficulty. This is particularly true if the person is overweight, has very muscular thighs or is short.".
This is true. Heavier patients are NOT good candidates for anterior, although, my own cousin is quite obese, and had the anterior procedure 2 years ago, and was back in form within a month. She had a much better recovery than I had anticipated given her size.
For those that want a faster recovery, anterior is absolutely the way to go, provided your surgeon is EXPERIENCED in that procedure. That is THE MOST IMPORTANT point. Most studies on recoveries don't even cover the few weeks right after surgery. and that is where you see the big differences.
"Michael Alexiades, MD, a hip and knee surgeon at Hospital for Special Surgery, in New York City, specializes in the anterior approach. He agrees that patients should go with the approach their surgeon has the most experience with. He says that in his view, while both surgeries produce the same results long term, he believes differences are visible in the first six weeks after surgery – a time period not evaluated in this or other studies.
“The chief goal of any of the approaches is that five, 10 or 15 years down the line, the procedure is still holding up and patients all are doing the same. When we get into arguments of which is better, you are looking at the very short-term results,” Dr. Alexiades explains. “To the patient that wants to get back to normal daily activities, they will seek out surgeons adept at doing the anterior approach. For the retired patient who may not be in a rush to get back to working or driving sooner, it may not make that much of a difference. And with the anterior approach there can be complications in older individuals with osteoporosis such as fractures at time of surgery.”
He also notes that the anterior approach may not be the best option for someone who is obese or has muscular thighs, because extra soft tissue can make it harder for the surgeon to reach the hip joint."
"What has been proven in terms of scientific studies is that although the initial recovery is faster with the anterior approach, at three months there is no difference between well placed total hips done with the anterior approach versus the posterior approach. The key phrase here is "well placed.” I used the posterior approach for all hip replacements I performed from 1983 until late in 2013. From that point on, I have used the anterior approach to hip replacement almost exclusively for primary hip replacement and have even used it on selective revision surgery. My frustration with the posterior approach was achieving well placed components on a consistent basis, in particular the acetabular component. (The acetabular is a concave surface of the pelvis. The head of the femur meets with the pelvis at the acetabulum, forming the hip joint.) Proper placement of total hip components is one of the key factors in achieving excellent long term results with a total hip replacement. In my hands, I feel like proper placement of the components is something that is much more consistent with the anterior approach.
Total hip replacement is carried out via the posterior approach about 2/3 of the time in this country. The anterior approach is done about 25% of the time and other approaches account for the remainder. The posterior approach is what has been taught in most orthopaedic training programs across the country, because it is versatile and most problems with the hip joint can be addressed with the posterior approach. This includes femoral neck hip fractures and hip replacement for arthritic conditions. The anterior approach is not a new approach and has been around since the early 20th century. Its' widespread use has not occurred since it literally is 180 degrees from the posterior approach in terms of how the surgeon views the hip anatomy. Quite frankly it is an approach that can be daunting until the surgeon becomes use to it and learns the strengths and weaknesses that it presents. So why would someone who was very comfortable with the posterior approach switch to the anterior approach? In a nutshell because I feel like my patients have better results and fewer complications. I have no scientific proof of this other than what I have seen on a daily basis with my own patients."
I am obese and had the anterior approach done with absolutely no problems. Like I said once I heard that a THR was in my future I did my research and saw anterior was the way to go.
I was seeing one Orthopedic Group in town and the head of the group was my hip guy. He said they only did Posterior. I took a little tumble (caused in part by my hip), and when emergency room scheduled me to see someone, I ensured it was the other big Ortho Group in town. I knew they did Anterior.
Asked then about it and they said they had done it on bigger guys than me. I had a few questions I needed answered (like the special operating table) and I was set to go.
Anyone in the North Florida area needs one I highly recommend Dr Picerno at Baptist South in Jacksonville.
OP -- regardless of how or when surgery is performed, talk to the surgeon about everything. Find out about the various pain medications that are likely to be prescribed during recovery. Some have side effects. Some should probably be reduced gradually rather than 'cold turkey'. Some sooner than others.
There are even options on anesthesia during the surgery. I had a spinal block and was groggy but mostly awake during the surgery. I don't handle anesthesia very well based on experience from earlier surgeries so that was the best option for me. Some folks might need a different option.
Some surgeons (mine, for example) don't recommend physical therapy for any extended period after being able to manage at home. Walking was the preferred therapy. That worked for me. Something else to discuss.
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