Best approach for hip replacement

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.

Good point on how to select an approach to hip replacement. My Dr uses an anterior incision, and it is a much smaller incision and far less traumatic than posterior.

Joe

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.

Interesting. I did not do much research. I had two doctors. The older said if you need hip replacement do Anterior. A couple years later, he had a replacement at Mayo, I believe went well, since he resumed skiing.
This pain and numbness is no joke.

Let me know if injections work for you. I’m taking 600mg of gabapentin currently and almost at 6 months post op. I’m numb on the side of my leg and have occasional electrical nerve jolts also. You’re lucky, I guess, that you don’t have it on your first hip! ; )

I had a THR almost two years ago. I am 78. It took a long time of PT but the hip moves very well. The muscle on my front thigh remains numb to the touch and painful if I bump or push on it. I had the anterior by a surgeon who did 30 plus per month for many years. I am very happy with the end result and just live with the muscle problem. I could barely walk before surgery the hip bones were disintegrating.

I too had complications after second hip replacement but not first. The nerve was impacted and now dealing with this. Just started Gabapentin. I actually feel better today. Weird! Oh and yes Anterior.

Update, didn't want to take the Gabapentin but oddly I feel better this morning for reasons I can't explain. Long conversation, I did not want to do injections so I guess its meds and see if this helps long term. He said the nerve heals at a very slow rate.
Caveat, I think this is a great site. It gives people a good example of what you can potentially go through after any surgery. Everyone is different and results may vary. I also think its confidence in your doctor. You can get a second opinion. I was lucky that my first surgery was ok. I will check in to see what's going on with everyone. Good luck and good health to you.

I had a THR on both hips. I would disagree with many things people say here and want to offer that readers take all of our comments and experiences with consideration, but not absolution. One thing I can say is nerve damage can always be a possibility, but it’s more complicated than stated here. One problem is that nerve damage can be emanating from your spine and THR does not solve that problem. Most people don’t even know that they might have pain starting from their spine. Sometimes a hip replacement doctor can’t be held responsible for the lumbar spine because they are specialists. So in my case, I had to go through all of it one joint at a time to learn that some of my pain wasn’t resolved until we got to the spine. And even after two hips and a spine surgery, we found out that my tailbone is responsible for some of my pain.
I also want to say that scar tissue can be a problem in any surgery as new thing and that can show up, but it also can be resolved.
The idea of being a couch potato has to be taken in context! Hospitals and doctors immediately get you up to get you mobile after surgery! To have you be a couch potato for five months leads to serious muscle atrophy and will complicate all aspects of recovery. Doctors mightsay you can’t bend or twist. Exercising strategies need to become part of your own personal program, depending on which type of THR surgery you choose.
In some surgeries, you absolutely must be careful you don’t dislocate your new hip. But with support, protection, knowing what movement has to be avoided, and what can be helpful onwards you go. I can tell you from five joint replacement surgeries that being a couch potato for five months is a crazy idea because of the amount of muscle that would be destroyed and can’t be reestablishedonce you get to geriatric age. A lot of doctors are fearful that their patients will dislocate their new hip - so maybe that is the context in which that was said. I had a difficult time healing from my first hip replacement surgery and my Doctor (beloved in San Diego) did much better on my second THR on the other hip because he “learned my body.“ My healing time was cut in half. But through my five total joint replacement surgeries there are certain schedules that seem to be consistent and need time. I have a three month marker, a five month marker, and a one year marker at which my life becomes much easier. But all of these required doing the exercises which are administered after surgery and instructed by a physical therapist starting in the hospital. Then someone comes to your house to make sure you are doing the exercises, then you’re monitored on your postop visits and your doctor will adjust and tell you what you can and can’t do.
What you will find in this forum is people who don’t exercise have complications because their muscles have atrophied, because they’ve developed scar tissue, or become pacified with nerve medication instead of exercise, and who eventually suffer with neuropathies and reticulopathy (nerve pain) because supporting muscular is no longer working properly and the nerves are acting out..
There is so much information out there about hip surgeries, exercises, etc. that I recommend you spend the needed time informing yourself and getting opinions until you feel you can trust someone with your body.
I am by myself and I had to hire strangers to take care of me for two weeks after each THR surgery. Then I made a schedule of neighbors or cousins who would come for a little while to help with shopping or comfort and that was for about six weeks. If you are on your own, there is no being a couch potato and getting up is the most important thing you can do. It was mandatory that I get up for breakfast, lunch and dinner being on the pain. Medication was the only way I could start with the movement and the exercise. But it requires careful guidance as we are destabilized by the medication and falling or dislocating would be the worst thing to happen. So in that regard not being an overachiever and being a couch potato might be appropriate.
I had anterior on both. I got my life back and I couldn’t be happier. It’s been 13 years for one surgery and 11 years on the other hip. Good luck!

Yes now that I know about the possibility of nerve damage I am fortunate. I have opted for this time, no injections but a course of Gabapentin.