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Conflicting Recommendations - Hip Replacement

Joint Replacements | Last Active: Apr 26, 2023 | Replies (17)

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@steveinarizona

I agree. But I would add that there are three different major approaches to THR: Posterior, Anterior and Superpath. Surgeons tend to do one only as they get comfortable with the approach. Outcomes are pretty similar but pain control, time to recover, etc. are different.

The oldest approach is Posterior and I would not go to a surgeon who still used this as his principal method.

Direct Anterior was developed as a better approach with less invasive surgery. It is definitely an improvement on Posterior.

Superpath was developed as an improvement to Anterior. I just had my left hip replaced by the surgeon who developed Superpath (Jimmy Chow). He operated on me in the outpatient facility in the morning and I was home by mid afternoon. My instructions were to take oxycodone the first night and then until I didn't need it; Celebrex for pain; and extra strength tylenol for fever. I took the first oxy pill and then no more. After four days I asked my doctor's PA if I could stop taking the Celebrex and Tylenol and she said yes. Essentially, I have had no meaningful pain from the implant.

I also had pain below my knee which my internist thought was probably bursitis. Dr. Chow, my surgeon, who also does knees, said the x-ray was fine. Interestingly, to me, since my implant my knew is barely hurting and my hip is not hurting at all. My surgeon said that while his approach doesn't cut muscles, ligaments, etc., he can't make bones grow faster so his instructions were to try to be a couch potato for the first six weeks. So I reluctantly did and during the seventh week I went back to playing golf.

Bottom line: pick a surgeon who at least does anterior if not superpath and one who has done lots of the operations. I would focus on surgical skill, not bedside manor, for this process.

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Replies to "I agree. But I would add that there are three different major approaches to THR: Posterior,..."

Interesting to learn about the "Superpath" methodology. It sounds like a promising approach for many.
But...there is definitely a place in the surgeon's toolbox for the posterior approach so please do not dismiss it completely. My original THR's were done with a posterior approach because the surgeon needed a complete view of the femur and capsule due to concerns about the very small size of my bones, extensive bone erosion and concerns about exact placement. My revisions were done posterior as well due to extensive tissue erosion and a need to completely debride and clean the area.

I think the key to success in hip replacement is the experienced surgeon, as you recommended.
Sue