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Hip replacement surgical approaches

Posted by shoppingdiane @shoppingdiane, Jan 15 7:53pm

I was scheduled for bilateral hip replacement via anterior approach x2..cancelled x2 for infection risk..rescheduled again 02/05..during my preop, surgeon recommending posterior approach...says the HANA table used for anterior approach..the torque and extension of legs may exacerbate my back problem..bulging discs...lumbar is 5mm bulge..he says he doesn't want me to come back and say he worsened my back..he saw the MRI on first preop visit..he's leaving it to me...1 or both hips...anterior or posterior..nerve block with sedation for anterior approach, side lying with general anesthesia for posterior...freaks me out...if I had the original surgery date, I would have had anterior...now the switch...does anyone know how this HANA table might impact back issues, i.e., bulging discs S1/L5...to lumbar region?

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mackad2024 | @mackad2024 | Feb 11 9:25am
In reply to @daisy22 "Yes, I am going to go to a lawyer. It will be 2 years in April..." + (show)
@daisy22

Yes, I am going to go to a lawyer. It will be 2 years in April and things are not any better, so I think a lot went wrong damaging the nerves. I also have peripheral neuropathy in the left foot that is now going up the leg. I wish I'd done the hip replacement on the side. I think pulling the layers of muscle and nerves apart is now a good option.

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daisy22, Did you ever seek a second opinion, perhaps from a neurologist and/or another ortho doctor? In your last sentence, is "now" meant to be "not"? Please keep us posted.

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daisy22 | @daisy22 | Feb 11 11:21am

Yes, it should be not. I've seen neurologists, had EMG, seen ortho for my back and PT has done the most for me. I've seen 4 doctors and none will help me. Discouraging.

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hsminc | @hsminc | Feb 12 11:43am
In reply to @shoppingdiane "Thank you for your response. Did you opt for the anterior or posterior approach when you..." + (show)
@shoppingdiane

Thank you for your response. Did you opt for the anterior or posterior approach when you had your hip done? How was your recovery? Did your bulging discs worsen after the procedure or hamper your recovery?

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For your information: Mayo (Mark Pagnano et al) reviewed/contrasted outcomes for the posterior and anterior hip approaches several years ago and published the results. These surgeries were done by surgeons experienced with their chosen approach. I believe the results showed that outcomes were essentially equal.
Pagnano did two knees and one hip for me. All three went very well - easy. I did not have any of the issues that were described by a few patients in these papers. I was walking sans walker four days after my hip (mini posterior approach). You might find this and other articles interesting reading. Go to PubMed and search on A. Hart, J Arthroplasty Nov 2019 34(11) 2681-2685 Epub 2019 June 27

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harleygirl1949 | @harleygirl1949 | Feb 13 8:03am

I had an anterior approach ( not at Mayo). I had terrible pain in the front of my thigh immediately after surgery.
Dr. would not admit that it was a "femoral cutaneous injury" from the surgery. I got my hospital records and he DID have dictation in my records suspecting that. He then refused to see me again. I eventually had a femoral cutaneous nerve injection at a pain clinic. It did help. I still occasionally get a few sharp pains in the front of my thigh and it has been over 10 years ago.

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