I am at the first stages of arranging a hip replacement - and I understand there are two main routes a surgeon can take into the hip. The good old tried and tested route is posterior - but this maybe easier for the surgeon but requires quite an amount of postop discipline by the patient, sleeping on the back, not bending the leg, etc. But I understand there to be a more modern method, the Anterior route, which requires almost no postop discipline, and can be done almost on a day patient basis. But how do I find a surgeon who can and will do Anterior ?? I have tried to find and contact a number of surgeons but receive meaningless or no reply - and I don't want to pay out for any number of consultations only to find I am speaking to the wrong person.
So the question - how do I find a surgeon in middle England who can and will do a hip replacement using the Anterior approach ??
I asked my surgeon about this before I had my op and he said that he didn't do it and didn't know anybody who did. It's not very widely used. I had the posterior approach and at 8 weeks post op am very happy. I ditched my sticks at 2 weeks, could walk unaided 2 miles at 3 weeks, driving at 5 weeks and back to the gym at 6 weeks. Not without a certain amount of discomfort and I hated sleeping on my back but it was soon over. You can sleep on the non-operated side with a pillow between your legs from about 3 weeks. I did this and everything was fine. Don't worry about recovery with posterior. Go for it and good luck.
Find a first class surgeon who has done lots of hips and then go with whatever approach he uses. The surgeon is much more important than the type of incision. I had a brilliant surgeon, I had a lateral posterior and had very little limitations. Things have changed a lot over the years. Whatever approach you have this is a fairly traumatic op and you will find that you will suffer its effects in tiredness and healing. Also try and be as fit as possible before the op which will really help you afterwards.
In fact my surgeon used to do the anterior approach and stopped as he felt that less damage was done using the posterior approach. Anterior does seem to cause more nerve damage than posterior. However at end of the day in most cases either works fine.
Find the best most experienced Surgeon. Seems to be more problems on this forum with Anterior. I am in the USA. MY SURGEON HAS OVER 40 years experience and only does posterior. I went with the best experienced Doc I could find. My brother in law went with a younger guy Anterior approach. Numbness, groun pain, and other problems. But he bragged he had less restrictions for 6 months.
Dear John
I had my hip replacement twenty years ago and only needed one walking stich when I left hospital and threw it away within a couple of days. My only restriction was to avoid twisting my leg for the first month to allow the bone to grow into the prosthesis. I did not have any physio, I just walked and walked. I made a very quick brilliant recovery and soon returned to a physically demanding farming and building job.
After twenty years the poly spacer wore out and so last year I had a revision. Both surgeries were done using the posterior approach.
Whilst the interior approach is promoted by some hospitals for money reasons, do be aware of the dangers of this approach. The main one is nerve damage that can give long term very painful problems.
Good luck, Richard
Hello John
I am due to have my operation on Nov 6th. I'm having it done the posterior approach, as a day case! I am in the North East, in Northumberland. I asked my surgeon about the anterior approach, but he said research shows that the posterior approach has a more proven track record.
My sister is having the anterior approach done in the Republic of Ireland at the end of November, as a private patient, I'm having done through the NHS. It'll be interesting comparing notes later on, but that's not helpful to you right now!
Elizabeth, you will have to keep us informed on both of your recoveries. I will be interested in the different approaches. You will also have competition, which will egg you on to recover more quickly. Good luck for november.
I can only warn you of the anterior approach from my experience. I am now 7 months post op and during surgery (anterior) my sciatic nerve was stretched. One part is dead and will never recover. My hip has been wonderful, no problems there at all. But the back of my leg all the way down to the bottom of my foot is numb. I have neuropathy in my foot from the nerve damage. My foot stays swollen making it harder to walk. I was in 6 months physical therapy and discharged because I had gone as far as they could get me. I'm blessed that I can walk unaided now but not far, as the leg and foot fatigue fast. Do your research but if I have the other one done it will be the posterior approach.
You poor thing. I must admit that was the reason that I preferred to have the posterior approach as I was so worried about nerve problems. I noticed on my surgeon’s notes that he had said protection of sciatic nerve during the op.
I am in the US but my doctor explained to me that my hips were made in a way that required to have posterior. He said anterior would not have worked for me. I understand that the anterior does not have the restrictions the posterior have. When I had the first surgery in January it was hard on me afterwards sleeping on my back for three weeks until I found out it was much easier sleeping in my recliner. When I had the second surgery I slept on my back maybe a week. I was on my left hip sleeping or in my recliner. I have notice mostly every one that can have the anterior is doing so. I wish you well in your quest for the best approach.