What exactly is posterior surgery? Mine was on my side flank. Although highly educated, I am still ignorant in regards to this.
There are two main types of incision are posterior and anterior. The posterior is as it implies more to the back of the hip, this is the old tried and tested way. It tends to have a larger scar and there are supposed to be more initial restrictions on movement for a few weeks. The anterior is more modern and the incision is at the front of the hip. The incision tends to be much smaller. The disadvantage of the posterior is that muscles need to cut, while the anterior they do not, however because the surgeon has less room to manoeuvre nerve damage and tendon damage can happen more easily. I had lateral posterior and in fact had no restrictions for some unknown reason, I think they are improving over time. I went out for lunch five days after surgery, although I think I may have been slightly over enthusiastic as you do get quite tired initially.
Just behind the hip, along the outer buttock area approx 4–6 inches. Larger incisions may be needed for larger patients and those with previous surgery or abnormal anatomy. It's the most common approach. No clinical studies prove which of the many approaches is better.
The posterior approach surgery has the incision on the side of the hip, just behind the greater trochanter, the hip bone that people feel on their side. That sounds like what you had. It cuts more muscle and soft tissue supposedly than the anterior approach, which has a much smaller incision on the front of the hip. My understanding is that with the anterior approach, you do have much faster healing and less soft tissue/muscle damage to contend with, but a slightly greater risk of nerve injury. There is also the slightly less invasive mini-posterior approach which is what I had supposedly. Again, supposedly the muscles at the back of the hip in this approach are separated rather than cut and the incision is a bit shorter than the traditional posterior. I'm no expert Ducksoup, but I hope this is what you were asking about.
Again, mine was in the side, where my hand hangs. Scar around 6-7 inches. I don’t know what you would call that. It would seem that posterior would even prevent sitting?
Yes Duck, you had posterior. My scar is about 9-10” and proud of it. My surgeon only does posterior approach and has over 40+ years experience. I sense better long term results with posterior but a few more restrictions first 6 weeks
Hi Ducksoup... I had what I thought was called a lateral THR which like yours is a vertical scar approximately 6inches in length. My friend had a posteria and it was as it says on the tin. Scar starts above the hip and as it goes down it runs along the bottom of your buttock (Cheek) Anterior is in the groin. Think lateral (vertical) incision is more commonly used NHS.
Kim, I had anterior, but my scar is definitely not in the groin area. It is more to the side.
Just as ptolemy says .... there are many medical terms used to blind the non-medically trained.
Posterior - Rear incision for THR
Anterior - Frontal incision for THR
Lateral - Side incision for THR
Proximal - closest to the body - i.e. the top of a leg
Distal - most distant part - i.e. the bottom of the leg
DS-
There is surgeon in Seattle whose website has a very good description and graphics to explain several of the most common procedures. You could google J Pritchet Orthopedic Seattle and find some good information.
From what I can understand it is not describing the position of the incision but the aspect that the surgeon approches the hip joint from ie front or back of the hip the position of the incision is a result of this
Hi m05, you are absolutely correct. It seems to be more common and easier for non medical people to talk about the approaches in terms of the incision. But that’s what it’s all about, where the surgeon approaches the hip joint from. Thanks for bringing up this important point.
I am having my surgery tomorrow morning and my surgeon will use a posterior approach. A little posterior to the midline of my hip and a longer scar than the anterior. He explained that he only uses this in his practice. In the anterior approach, the surgeon has considerable less visibility to do what’s needed, and as I read only certain implants can be used with this approach. True, the muscles need to be cut, but it in my case they are torn anyway so he can trim them if needed. There are a few more restrictions with the posterior, but Im OK with that if he gets the job done right the first time. The important thing to remember I think, is to be sure you have confidence in the surgeons ability and judgement, and he uses an the implant you want. There are many good surgeons who are confident with the anterior approach and I’m not dissing that. For me, the surgeon’s experience and implant choice was my overriding decision criteria.
I agree about having confidence in the surgeon's ability. That's why I decided to have the surgery soon after it was presented to me as an option. Didn't want to continue with pain.
Special thoughts going to you for your surgery.
I had a posterior THR in 2015. Very small scar (about 3 inches) and the muscles were NOT cut - they were merely stretched. Up and walking the same day. And no crutch/stick after 3 weeks. Perhaps it’s up to the individual surgeon which approach they prefer. And their skill of course.
Hi Maryboo, hope the op went well. I went for the posterior approach too as I felt that I would like the surgeon to have as much room as possible to do the op. Also I was not particularly worried about a larger scar. In fact I had no restrictions for some unknown reason although I was careful just in case. I did not use a stick or crutches in the house when I got home either, although I did furniture surf. The surgeon I had has a very good reputation which is probably the most important thing.
That is interesting, I had a lateral posterior and did not seem to have the problems most people seem to have with cut muscles. My scar was quite large though. I had no restrictions so perhaps the posterior approach is coming on by leaps and bounds. I never used a stick or crutches in the house but just furniture surfed. It is up to the individual surgeon which approach they use as there are different techniques and they need to be trained in them.
Well the dirty deed is done and I can say the hip feels better than it has in a long time. Sharp poking pain if the pill wears off, but all in all a way way better day than I imagined. I did stay on top of pain meds and was up walking a short way 4 1/2 hours post op. They used a spinal with sedation and i was worried I would not be asleep enough. No problem. They told me with a spinalanesthetic the throat tube doesn’t need to go as far down into the lung like general. Also less nausea and wake up more alert. All true for me. Best of all there would be pain relief longer. I was previously afraid the hip would be thawed out and they would have to wait till my toes came alive for any pain relief, but it worked out fine.
He used a smaller size implant because he said when he got in, the bones were smaller than he was estimating. Ha. There goes my diet excuse! I have ice on hip and the pressure socks. Aspirin for anticoagulant. I am glad I took the pain pill 45 mins before PT. That might have caused some weeping.
Regarding the incision position, when I stand ang my arm hangs down at my side, it lies thumb level just behind the hand.
The thing that bothers me the most is that wedge between my legs. Feels like I’m stuck to the mattress with Velcro.
Hope this gives some measure of comfort to those waiting and anxious hippies. Thank you all for the kind advice and I’ll post more in the coming days.
Great to hear the surgery is completed and you are very positive about it. As you begin the recovery process, there will be many changes/improvements with how you feel and what you are able to do. Keep in mind that it takes time. Someone told me that after surgery and it helped me a lot. Most important is that you have a brand new hip that will work better than the original.
Keep posting your progress. Might want to create a new "discussion" so it can be followed easily.
Congratulations! Amazing how you have the presence of mind to write a in depth description after surgery.
Thank you for all you shared valuable information for many hippies .
Many healing blessings sent your way! 🌷