… New Procedure May Replace Traditional Hip Replacement Surgery Subchondroplasty involves an injection of bone substitute. AARP members receive exclusive member benefits & affect social change. Which approach is better? Dr. Salyapongse explains, "Although the basic concepts of hip replacement surgery remain the same with both the posterior and anterior approach surgery, there are some key differences." However, this is not the case with hip replacement. In the meantime, please feel free Mayo Clinic in Rochester, Minn., and Mayo Clinic in Phoenix/Scottsdale, Ariz., are ranked among the Best Hospitals for orthopedics by U.S. News & World Report. Get matched to a top surgeon near you or book a free consultation with Dr. Salyapongse. Subchondroplasty also eliminates the risk of implants wearing out, requiring additional surgery, a problem that younger and physically active hip-replacement patients can face. U.S. News also ranks the best hospitals for hip replacement surgery using data on patient survival, nurse staffing, volume and more. Total hip replacement surgery involves removing the diseased portion of the hip joint and replacing it with an artificial hip, called a prosthesis. We love telling people about what we're doing! In addition, not having as many restrictive "hip precautions" after surgery is a massive bonus for many patients. Of these, osteoarthritis accounts for the majority of patients needing a hip replacement operation. Hip replacement surgery is a procedure in which a doctor surgically removes a painful hip joint with arthritis and replaces it with an artificial joint often made from metal and plastic components. The traditional surgical approach to total hip replacement uses a single, long incision to view and access the hip joint. This means that some surgeons are not as well-versed in the anterior approach. The goal of using shorter incisions is to reduce pain and speed recovery. During surgery, your doctor makes an incision in the front of your hip to reach the hip joint. Asking orthopedic surgeons what hip replacement is best is like going to a car show and asking people which car is best. Most surgeons use the posterior approach for hip replacement surgery. I just recently, three months ago had a total hip replacement by the anterior method, My surgery was at 7:30 and I was home by lunchtime, I walked out of the “hospital” actually outpatient facility with my walker. This surgery may be a choice after a hip fracture or for severe pain because of arthritis. Dr. Salyapongse touches on later recovery, sharing that "some studies show that even at 6 weeks, anterior hip surgery patients are still doing better than the posterior hip patients. 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. The cup is typically made of metal and fits into the natural hip socket. We explain the difference between hip replacement options: a traditional posterior surgery and the … Surgeons should stop carrying out a common type of hip replacement operation on women because of … The Lancet. Hip replacement (total hip arthroplasty) is surgery to replace a worn-out or damaged hip joint. The patient is typically lying on his or her side, and the hip is approached on the side and then around the front (anterior) portion of the hip. To replicate the action of your natural joint, a total hip replacement has 4 parts: a socket (cup), liner, ball (head) and stem. In an anterior approach, the replacement is done through the front while you lay on your back. Hip pain caused by this damage can be treated in several ways. Of all the joints currently replaced in the human body, the hip joint has had the most success, the quickest recovery, and is the most durable. The more procedures the surgeon has performed, the better they will be at providing you with a great outcome." According to the American Association of Orthopaedic Surgeons, more than 200,000 hip replacements are performed each year. they've performed more than 1000 procedures) then I would consider doing so. by Candy Sagon, July 30, 2012 | Comments: 0 Since each implant is very di… To get to the bottom of the "anterior vs. posterior" debate, we spoke with top orthopedic surgeon, Dr. Aaron K. Salyapongse. A new hip replacement strategy, an anterior approach technique, allows the patient to experience less pain, have a quicker recovery, and improved mobility. Dr. Salyapongse adds that the anterior approach can sometimes be "more accurate" because x-ray guidance and technology is used during the procedure. After this, standard hip replacement surgery is performed. “But when there is a complication, it’s not pleasant. Vasileff says he has used the procedure to repair the hips of patients from their 20s to 50s, but he thinks it also would work on older patients as long as they don’t already have a lot of arthritis. These parts mimic the way a normal hip joint works. Anterior hip replacement is done with the patient lying on their back on a special table that allows precise positioning of the affected leg. Both surgeons point out that the most important determining factor actually lies in your choice surgeon. Read on as we explain what the anterior approach is, how it differs from posterior, and share the pros and cons of an anterior hip replacement. A. In saying this, like most things in life, the more you know, the better you can do. The decision to undergo a total hip replacement involves a number of considerations, including choosing the surgical approach that is best for you. again. During hip replacement, a surgeon removes the damaged sections of your hip joint and replaces them with parts usually constructed of metal, ceramic and very hard plastic. Free chapter from AARP’s book by Dr. Sanjay Gupta. He's performed thousands of successful hip and knee replacements, making him a true topic expert. Traditionally, orthopedic surgeons have approached the hip joint from the side and back when doing total replacement surgery. Total hip replacement. But now, orthopedic surgeons are employing a new, easier alternative called subchondroplasty, in which a damaged hip is strengthened by injecting a cement-like material. The hip replacement operation has become a routine procedure. However, the most critical factor to the success of an anterior hip replacement is having a surgeon who you're comfortable with, has performed a high-volume of anterior replacements, and matches your individual needs. The posterior approach to total hip replacement is the most commonly used method and allows the surgeon excellent visibility of the joint, more precise placement of implants and is minimally invasive. www.aarp.org/volunteer. If a thigh-bone fracture occurs during hip resurfacing, the surgeons have no option but to continue with the total hip replacement procedure. Some of the commonly cited downsides to the anterior approach is that it is less common and hasn't been done for as long as the posterior. Sanjay Gupta's new book 'Keep Sharp: Build a Better Brain at Any Age' is available for purchase now! During hip replacement surgery, the damaged bone and cartilage are removed from the hip joint. In saying this, having a replacement done by an experienced surgeon you're comfortable with is the top priority. Hip | Total Joint Replacement. The advantage is thought to be that rehabilitation can proceed more quickly by not having to allow the reattached muscle to heal. This approach is often considered the  "latest and greatest" in hip replacement surgery. This type of surgery is just as safe and effective as traditional hip surgery, but with quicker recovery times. When it comes to your health, you should always be careful what you read online. During hip replacement, a surgeon removes the damaged sections of your hip joint and replaces them with parts usually constructed of metal, ceramic and very hard plastic. The new procedure injects a cement-like material into the damaged hip which solidifies within minutes. 2019; doi:10.1016S0140-6736(18)31665-9. Find out about the risks of hip replacement surgery. Anterior or posterior? AARP is a nonprofit, nonpartisan organization that empowers people to choose how they live as they age. The size and placement of the incisions will be different. Orthopedic surgeon, Dr. Trevor North echoes a similar perspective, saying "the most important thing when deciding your joint replacement approach is the relationship you have with your surgeon". In short, both approaches result in a hip replacement. If your hip pain is not responding to non-surgical treatment methods such as physical therapy and medication, your doctor may recommend total hip replacement surgery. Hip replacement surgery usually takes 2 to 3 hours. Dr. Salyapongse is a popular orthopedist who operates out of Dublin, California and Pleasanton, California. The hip joint is where the head of the thigh bone or femur meets the pelvis. Best Hospitals for Hip Replacement Hip replacement surgery is usually recommended when a person has extreme inflammation and arthritis in the hip joint, making it painful to do daily activities. The procedure should relieve a painful hip joint, making walking easier. However, the difference between the approach is where the incision is made to access the hip. The other is the lateral approach. Read on, mate. Surgeons who typically perform at least 100 hip replacement procedures per year are in the best position to adopt shorter incisions, while keeping the procedure the same. Other reasons for hip replacement include injury, infection, and brittle bones. An X-ray of the pelvic area, showing a metal replacement hip. Because of these benefits, the anterior approach to total hip replacement is especially appropriate if you are active and eager to return to work and daily activities as soon as possible. Eligibility for the Anterior Approach to Total Hip Replacement Surgery. The anterior approach hip replacement is a muscle-splitting approach, meaning that the surgeon gets to the hip between two muscles, rather than by removing and then reattaching a muscle. Become part of the PeerWell community on social media. What is hip replacement? This artificial joint (prosthesis) helps reduce pain and improve function.Also called total hip arthroplasty, hip replacement surgery may be an option for you if your hip pain interferes with daily activities and more-conservative treatments haven't helped or are no longer ef… The Anterior hip approach has a higher complication rate in inexperienced users and there is no data showing better long term outcomes. by Patrick Kiger, AARP, January 18, 2018 A. Without a doubt this can make for an easier "return to normal"  and underscores a possible jumpstart on recovery. But importantly regarding pre hip replacement, the hip needs to be identified as the source of pain and dysfuncton, and any back issues need to be identified and treated before Hip replacement. Advocates say it’s easier, less invasive, and has a … This can mean faster healing. You must be logged in to leave a comment. Read on as we explain what the anterior approach is, how it differs from posterior, and share the pros and cons of an anterior hip replacement. You can also manage your communication preferences by updating your account at anytime. Then they inject the cement-like material, which solidifies within minutes. An example of such an incision is illustrated in Figure 1. Its not !The best method is one hat allows the surgeon to accurately implant the best prosthesis in the correct position. In other words, in cases of patients who've had bilateral hip replacements (whether staggered by weeks or years, or done at the same time), notable feedback is that they preferred the anterior replacement. Osteoarthritis is painful as joints become stiff and inflamed when the smooth lining between the joints gets damaged or wears away. According to Vasileff, recovering from a subchondroplasty is far less arduous than a total hip replacement, in which surgeons completely remove the damaged femoral head and the cartilage surface of the socket and replace them with artificial parts. In many cases, well-trained surgeons using special instruments can shorten the incision of a standard hip replacement to about 4 inches. To replicate the action of your natural joint, a total hip replacement has 4 parts: a socket (cup), liner, ball (head) and stem. This can be caused by osteoarthritis or a previous injury to the hip. 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