Best approach for hip replacement

This can be a confusing subject, with pros and cons to both types of surgery. You can read a comparison of the 2 approaches here:
https://www.arthritis-health.com/surgery/hip-surgery/advantages-and-disadvantages-anterior-hip-replacement
I believe that any time a scalpel comes in contact with my body, there is some risk (however small) of one or more nerves being damaged. According to the review above the risk exists in any hip replacement. You might want to ask the surgeon what he meant - he might have said he doesn't cut any nerves, but that doesn't mean disturbed nerves won't be unhappy.

sorry to post so late.

First, I would run away from any doctor who "assured" a patient that there would be no nerve pain. I agree with Sue completely on this.

As to approach, I went with the newer, third approach: Superpath. It uses the least invasive approach of all. My surgeon walked into the outpatient surgery center holding a document of about ten pages in length and said something like: This is the hospital's instructions on what to do after a hip replacement. Don't bend over, etc. ". He then tossed it in the waste paper basket and said: I have only two instructions: (1) take your medicine; and (2) be a couch potato for five weeks because the one thing I can't do is make bones grow.

The medicine was oxycodone and Celebrex. The instructions were to take one oxy the first night, then continue it until I didn't need it any longer and then taper off. I had zero pain so the next morning I called and asked if I could skip the oxy. They said yes. Two days later I still had no pain and repeated the call regarding celebrex. Again they said sure...go ahead and stop it.

I never did have any pain from the implant.

But I have one very important caveat: As much as I prefer Superpath to Anterior and Anterior to Posterior, if the surgeon had done only ten superpaths and thousands of posteriors, and that was my only surgeon, I would go for the posterior. These are complex operations and you want someone who has done it a lot. Mine had done thousands of Superpaths.

Hi, I had Anterior Hip Replacement January 2025. I researched both options of posterior and anterior with 3 different doctors. I chose anterior because I didn’t want my gluteus muscle cut and was concerned about the dislocation possibility with the posterior and the restrictions. I did read that most people at 3 months are at the same place in recovery regardless of which procedure they have…ie, posterior or anterior.
I’m 3 month post surgery and my hip feels great. I had the Mako robotic surgery.
I am however experiencing numbness and a lot of nerve pain on the side of my leg due to having the anterior approach. I started taking Gabapentin within the first week of recovery and it seemed to help. At 2 1/2 months post recovery I tried to ween off of Gabapentin and when I got down to 1 dose (100 mg) I started having sharp electric pains in my outer thigh. I started back on Gabapentin 100mg 3x a day and it wasn’t enough now. I’m now taking 200mg 3x daily and it’s not helping. I’m hoping that the nerve pain I’m feeling is the nerves trying to reconnect to each other. Hopeful thinking at this point but if this doesn’t resolve I will seek a doctor who deals with correcting the nerve pain.
I might have to do my second hip in the future. Would I do Anterior again? No, I don’t think I would. I was worried about nerve pain and now I’m thigh deep in it. I would feel almost perfect from hip replacement if I didn’t have the nerve pain. The incision at the front of my thigh is still painful because it’s right where the leg bends from the torso, but I know that will improve. I iced my hip for 2 months because I’m a big believer in ice therapy. I didn’t have any thigh swelling and any swelling around my incision is gone.
I’m an active 64 year old female and in good shape.
Best to you in your decision for your THR.

sorry to post so late.

First, I would run away from any doctor who "assured" a patient that there would be no nerve pain. I agree with Sue completely on this.

As to approach, I went with the newer, third approach: Superpath. It uses the least invasive approach of all. My surgeon walked into the outpatient surgery center holding a document of about ten pages in length and said something like: This is the hospital's instructions on what to do after a hip replacement. Don't bend over, etc. ". He then tossed it in the waste paper basket and said: I have only two instructions: (1) take your medicine; and (2) be a couch potato for five weeks because the one thing I can't do is make bones grow.

The medicine was oxycodone and Celebrex. The instructions were to take one oxy the first night, then continue it until I didn't need it any longer and then taper off. I had zero pain so the next morning I called and asked if I could skip the oxy. They said yes. Two days later I still had no pain and repeated the call regarding celebrex. Again they said sure...go ahead and stop it.

I never did have any pain from the implant.

But I have one very important caveat: As much as I prefer Superpath to Anterior and Anterior to Posterior, if the surgeon had done only ten superpaths and thousands of posteriors, and that was my only surgeon, I would go for the posterior. These are complex operations and you want someone who has done it a lot. Mine had done thousands of Superpaths.

I find your comments helpful. I had anterior first, no problems. Had a second 4 years later on other side, same doctor and have had many problems due to nerve damage. I didn't know that was a possibility. I am six months out and still much numbness and pain and electro jolts. This was unexpected. Now referring me to possible injections. Gabapentin didn't help.