1. < Bones, Joints & Muscles

Best approach for hip replacement

Posted by msvjv @msvjv, Jan 21 9:54am

Interested in outcomes from the three approaches for a hip replacement…anterior, posterior or lateral. Would much appreciate learning of your experiences. Advantages? Disadvantages? Recovery time? I live alone and want to be prepared.

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msvjv | @msvjv | 3 days ago
In reply to @daisy22 "I had the anterior surgery 3 years ago and still have leg numbness and tingling in..." + (show)
@daisy22

I had the anterior surgery 3 years ago and still have leg numbness and tingling in the thigh and down the leg to the foot. I know they says there's less chance of dislocation, but living with this is tiring. The nerves in the front are cut and, if they recover, it takes years. I also have L5-S1 spondylolisthesis and when my low back aches, that affects the leg as well. I'm just finishing PT for problems walking, stumbling, etc. and things are better but wish I hadn't done the anterior approach. i'm on a Mayo Clinic blog and people say the same thing and have heard this approach isn't being done as much. Good luck.

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Hi Daisy. I’ll try again. Where can I find the discussion you reference re the disadvantages of anterior approach?

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daisy22 | @daisy22 | 3 days ago
In reply to @msvjv "Hi Daisy. I’ll try again. Where can I find the discussion you reference re the disadvantages..." + (show)
@msvjv

Hi Daisy. I’ll try again. Where can I find the discussion you reference re the disadvantages of anterior approach?

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I'm on the bones, muscles and joints blog. I found the web site at Mayo regarding the cortisone shot quickly after the anterior approach to get ahead of the numbness and tingling. The web site is Mayo Clinic study finds nerve damage after hip surgery may be due to inflammation

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msvjv | @msvjv | 3 days ago
In reply to @daisy22 "I'm on the bones, muscles and joints blog. I found the web site at Mayo regarding..." + (show)
@daisy22

I'm on the bones, muscles and joints blog. I found the web site at Mayo regarding the cortisone shot quickly after the anterior approach to get ahead of the numbness and tingling. The web site is Mayo Clinic study finds nerve damage after hip surgery may be due to inflammation

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Thank you. Found it.

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kforrest | @kforrest | 3 days ago
In reply to @heyjoe415 "Thanks Peter. I'm glad your hip replacement went so well. I've had both knees replaced, with..." + (show)
@heyjoe415

Thanks Peter. I'm glad your hip replacement went so well. I've had both knees replaced, with terrific results, and I'll get my right hip replaced in June 2025.

As far as your lumbar and cervical spine - are you getting fusion, or something less intrusive? 10 years ago I had laminotomies at S1, L5, and L4 - a hole was drilled in those vertebrae to make more room for the sciatic nerve and relieve some of the pressure caused by stenosis and scoliosis. So far so good. I also maintain a very strong set of core muscles, and my surgeon tells me this is the best thing I can do for my spine (to avoid fusion).

As for anterior v posterior hip replacement, my understanding is that with a posterior incision the gluteus muscles have to be cut to get to the hip. Apparently these aren't minor cuts, and it increases post-op pain and takes longer to recover (or so I'm told).

With the anterior incision, the muscles are pulled apart to reach the hip. Someone mentioned that nerves were cut. I don't think this is ever intentional, but can happen in just about any surgery. My opinion is that anterior is better. I'll find out.

Surgeons choose a posterior incision for two reasons - 1) the surgeon simply doesn't have experience with the anterior approach, and/or 2) the patient may be carrying a lot of weight in the torso/belly and it's not viable to go the anterior route.

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does insurance cover all the costs?

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heyjoe415 | @heyjoe415 | 2 days ago

Does insurance cover the cost of a hip replacement? - asked by kforrest.

Well that depends on the diagnosis from the surgeon indicating a hip replacement isn necessary (to alleviate pain, improve gait, and on......), and it also depends on what type of insurance plan a person has.

I have a Medicare Advantage Plan through UHC and it covered everything, if I remember correctly, for my two knee replacements. At least I don't recall getting any invoices for the surgery. I do have a $35 copay for visits with a specialist in-network, but that's about it.

Finally, I'm pretty sure anyone with a Medicare Supplemental Plan would have all costs of a hip replacement covered. There may be some expense for drugs, and that depends on if a person has a Part D plan with Medicare.

I hope this helps. The surgeon will or should get prior authorization well before the surgery, but it never hurts to verify.

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