← Return to Anterior vs. posterior hip replacement (THR): How do you decide?

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@sueinmn

I'll try to give you a long term perspective. For reasons I don't need to address, I have had 2 total hip replacements and 3 revisions, over a period of 6 years. The last was in 2012, and I am doing fine, active and the only pain is from arthritis and a little bursitis.
In 2006 I had both total hips, 3 months apart. My original doc did both anterior and posterior, but would only consider posterior because the hips appeared to be badly eroded on xray and were pretty well frozen in the joints (I was only 55 and of very average weight - he said he expected someone over 85 based on the pics)
Healing time was about 2-3 weeks longer than for my cousin who had surgery at the same time. I was walking with crutches the day of surgery, and with barely a cane after 3-4 weeks, and dancing at 6 weeks.
At 5 years both implants failed and required revision, which the second surgeon did 6 weeks apart, posterior. He would not consider anterior (which he also does) because he said my small stature left "no room for even minor inaccuracy" which according to him is the biggest down side of the anterior approach where the doctor cannot see the joint as well. Those revisions, and a subsequent one were all done within an 8 week period -don't ever do that! The recovery time from 3 major surgeries with anesthesia and blood loss in that short time took a year. A relative my age and size talked her doc into an anterior incision at that time, her initial recovery was about a month shorter than mine. However her joint never aligned right and she still walks with a cane and pain.
Fast forward to 2020 - I barely remember the recovery time, but my hips were positioned exactly right, the scars don't look any worse than my friends' and everything works.
Also, at the times of my surgeries, each doc had done well over 1500 hip replacement surgeries, so I had confidence in their skill.
Here is another strong recommendation : Ask for at least a few a physical therapy sessions, especially if you have had a frozen joint or have been limping for a long time. At a minimum you need gait training to get you walking in such a way as to minimize stress on back and knees. Some strength and flexibility work is helpful as well. And do the recommended exercises as instructed. I am sure that was partly responsible for my success.

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Replies to "I'll try to give you a long term perspective. For reasons I don't need to address,..."

I have had two hip operations. One was ten years ago. I recovered well from it. I do not know what kind. It looks like a lateral or side one. I had a bad back and a second hip problem. I did the back first since the sciatic nerve was being destroy. They said the operation was risky. It came out ok. However, my hip became so bad, I needed hip replacement.. I had a posterior......my sister had had 2 anterior and swore by them. So I went to a well know doctor. I had horrible bone Spurs, bone on bone and bad arthritis. He only did posterior. He wanted to do a spinal but I refused having had surgery on the spine low. So I was put out. My problem was because I had had bad back surgery while doing the hip, he disturbed my sciatic nerve which was part of the back surgery. I was in terrible pain for weeks and he gave me steroid. Throughout the pain, the hip starting working well. What I found was that the latest incision was almost 50 percent longer and wider than first scar hip. He admitted he had to really move the nerve aside. My question is, if I had had an anterior hip replacement would he have had to bother this nerve?