More about hip surgery

Posted by cindiwass @cindiwass, May 16 8:35am

The doctor is wanting to use lateral decubitus position for the hip surgery, total hip replacement. I looked it up for pictures, that's the first one I looked at though. Looks a bit difficult in reference to my position on the table. For me. He says he has better success with that position but I am nervous (as usual) about it. I am wondering who here may have had lateral decubitus positioned surgery like that and how they feel. Also I am wondering about changing the length of the leg in reference to that type of surgery. He says lengths of legs, etc., are different anyway, which did not particularly assure me. Thanks.

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Good evening Cindi, nice you are asking all the questions. The approach your surgeon is using is the traditional approach, other same as I had successfully 5 times.
Here is how my trusted surgeon explains it. It gives the best view of the entire operative field, so any anomalies can be seen. There are simple, inexpensive positioning tools that are used to minimize the impact of pelvic ti.t on the first am position.

He also told me that everyone's legs are two different lengths, and unless it is problematic already, the goal is to keep them like they are.

Finally, he says that, contrary to what you might think, even though recovery in ideal situations is faster with the anterior approach, the complication rate is actually higher – especially risk of bad alignment.

So, my friend, you have done WAY more than your due diligence as a patient. Now it's time to put your trust in the surgeon and his team.

How about some relaxation breathing every morning and night to help you get through this?
Sue

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When I looked into the "anterior vs posterior" approach, I basically found out that (at least 7 years ago), *most* surgeons were still doing posterior because that was how they had been trained. Also, that doing the anterior approach required a special surgical table. I was repeatedly told that both types had good outcomes, but that the anterior healed more quickly.
Bottom line is that I had the anterior approach, and I was up walking in a few hours. Other than the wound healing, I had zero problems. I know I had a great surgeon that did know and use that approach, and that makes a big difference.
But I still would recommend anterior hip replacement surgery.

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@cindiwass I'm going to address the leg length difference you asked about.

I had a leg length difference of 3/4" due to a repaired congenital hip dysplasia when I was an infant. That hip, although successfully repaired, and the leg length difference has been a problem for my entire life but especially the last few years before surgery. My surgeon and I discussed this and he made an adjustment in my hip replacement so that the difference is now less than 1/4". I am now able to work on my gait and balance in a way I never could before surgery. But as I wrote, the leg length difference had always been problematic for me.

How much of a difference is your leg length? If that has been a problem for you then I suggest you discuss this with your surgeon.

As @sueinmn suggests, you have done plenty of work to get yourself ready for this surgery. Now it's time to go forward. How about breathing through your current pain and imagining what activities you may have put aside and can enjoy again after surgery?

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This is a question concerning after care and therapy after total hip replacement. I have been told that I will receive post operative care/therapy via FORCE THERAPUTICS. This is virtual patient education along with physical therapy and monitoring. Has anyone had any experience with this patient platform (good or bad). I would appreciated hearing any opinions about this type of virtual care.

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@birdman518

When I looked into the "anterior vs posterior" approach, I basically found out that (at least 7 years ago), *most* surgeons were still doing posterior because that was how they had been trained. Also, that doing the anterior approach required a special surgical table. I was repeatedly told that both types had good outcomes, but that the anterior healed more quickly.
Bottom line is that I had the anterior approach, and I was up walking in a few hours. Other than the wound healing, I had zero problems. I know I had a great surgeon that did know and use that approach, and that makes a big difference.
But I still would recommend anterior hip replacement surgery.

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Same here . I had no problems post hip surgery. Up walking afternoon of surgery .

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@sueinmn

Good evening Cindi, nice you are asking all the questions. The approach your surgeon is using is the traditional approach, other same as I had successfully 5 times.
Here is how my trusted surgeon explains it. It gives the best view of the entire operative field, so any anomalies can be seen. There are simple, inexpensive positioning tools that are used to minimize the impact of pelvic ti.t on the first am position.

He also told me that everyone's legs are two different lengths, and unless it is problematic already, the goal is to keep them like they are.

Finally, he says that, contrary to what you might think, even though recovery in ideal situations is faster with the anterior approach, the complication rate is actually higher – especially risk of bad alignment.

So, my friend, you have done WAY more than your due diligence as a patient. Now it's time to put your trust in the surgeon and his team.

How about some relaxation breathing every morning and night to help you get through this?
Sue

Jump to this post

๐Ÿ™‚ Thank you, thank you, thank you! So refreshing to know. May God bless you for your help and support. I'm going to surgeon today to see him before the operation. I do trust him but — yes — I get scared, but I must must must go ahead with this, come what may, because after the hip surgery I'm going to need knee surgery. Oh well, that's the price of getting old-er and being thrown down on the basketball court by some schoolmate in high school. After which I had knee surgery. But that's another story. I hope you are healing. Thank you so much!! @sueinmn

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@naturegirl5

@cindiwass I'm going to address the leg length difference you asked about.

I had a leg length difference of 3/4" due to a repaired congenital hip dysplasia when I was an infant. That hip, although successfully repaired, and the leg length difference has been a problem for my entire life but especially the last few years before surgery. My surgeon and I discussed this and he made an adjustment in my hip replacement so that the difference is now less than 1/4". I am now able to work on my gait and balance in a way I never could before surgery. But as I wrote, the leg length difference had always been problematic for me.

How much of a difference is your leg length? If that has been a problem for you then I suggest you discuss this with your surgeon.

As @sueinmn suggests, you have done plenty of work to get yourself ready for this surgery. Now it's time to go forward. How about breathing through your current pain and imagining what activities you may have put aside and can enjoy again after surgery?

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@naturegirl5 thank you as well so much. Yes, yes, the time has come. I should write out your response and @sueinmn's responses for encouragement and remember it. I'm going to pray because I do trust my surgeon. I might tease him and tell him I hope he gets a good night's sleep beforehand. ๐Ÿ™‚ But maybe I won't. ๐Ÿ™‚
So thank you so much for all your kind encouragement.
As for the leg shorter, I have not noticed a problem, but who knows after that basketball game where my knee was injured years ago and I had an operation on that like over 50 years ago. But the surgeon did a good job, however naturally it continued to deteriorate although I had pretty good service from it for about 30 years. But now the real trouble with pain is in the hip joint. So thanks again. You have been very encouraging.

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@birdman518

When I looked into the "anterior vs posterior" approach, I basically found out that (at least 7 years ago), *most* surgeons were still doing posterior because that was how they had been trained. Also, that doing the anterior approach required a special surgical table. I was repeatedly told that both types had good outcomes, but that the anterior healed more quickly.
Bottom line is that I had the anterior approach, and I was up walking in a few hours. Other than the wound healing, I had zero problems. I know I had a great surgeon that did know and use that approach, and that makes a big difference.
But I still would recommend anterior hip replacement surgery.

Jump to this post

The big problem that frightens me (although I am working on putting trust in my surgeon) is the position I'll be in during the surgery — I saw pictures on the internet about that and it looks formidable. However, once again, the surgeon has an excellent rating, he certainly seems competent enough, so he has my trust. I am seeing him today but I doubt I'll ask him as to what position I'll be in during the surgery — I don't want my pressure to get any higher…:-) Take care, thank you for your response. P.S. I am a little bit frightened about the post surgical recovery. I toss and turn all night long. I'm also concerned about restrictions in my movement after the surgery for the rest of my life if I don't dislocate the ball and joint. Oh well, I guess I'm a worry wart. My husband is not like that, but I have helped him to ask questions and double-check on things. OK, I guess I just have to trust in God and the surgeon at this point for a safe enough recovery, because I can't function with the pain I'm going through now anyway.

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@cindiwass

The big problem that frightens me (although I am working on putting trust in my surgeon) is the position I'll be in during the surgery — I saw pictures on the internet about that and it looks formidable. However, once again, the surgeon has an excellent rating, he certainly seems competent enough, so he has my trust. I am seeing him today but I doubt I'll ask him as to what position I'll be in during the surgery — I don't want my pressure to get any higher…:-) Take care, thank you for your response. P.S. I am a little bit frightened about the post surgical recovery. I toss and turn all night long. I'm also concerned about restrictions in my movement after the surgery for the rest of my life if I don't dislocate the ball and joint. Oh well, I guess I'm a worry wart. My husband is not like that, but I have helped him to ask questions and double-check on things. OK, I guess I just have to trust in God and the surgeon at this point for a safe enough recovery, because I can't function with the pain I'm going through now anyway.

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Once you make up your mind, the beauty of anesthesia is that you wake up and it's over. For me, my left hip replacement was a non-issue for me after it was done.
I wish you the best!

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@cindiwass

The big problem that frightens me (although I am working on putting trust in my surgeon) is the position I'll be in during the surgery — I saw pictures on the internet about that and it looks formidable. However, once again, the surgeon has an excellent rating, he certainly seems competent enough, so he has my trust. I am seeing him today but I doubt I'll ask him as to what position I'll be in during the surgery — I don't want my pressure to get any higher…:-) Take care, thank you for your response. P.S. I am a little bit frightened about the post surgical recovery. I toss and turn all night long. I'm also concerned about restrictions in my movement after the surgery for the rest of my life if I don't dislocate the ball and joint. Oh well, I guess I'm a worry wart. My husband is not like that, but I have helped him to ask questions and double-check on things. OK, I guess I just have to trust in God and the surgeon at this point for a safe enough recovery, because I can't function with the pain I'm going through now anyway.

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"The big problem that frightens me (although I am working on putting trust in my surgeon) is the position I'll be in during the surgery โ€” I saw pictures on the internet about that and it looks formidable. " Well, Cindi, that's why they put you to sleep before they wrangle you into position, and lay you on your back before they wake you up! You'll never even know.

"I'm also concerned about restrictions in my movement after the surgery for the rest of my life if I don't dislocate the ball and joint. " Well, the restrictions are not nearly so bad as you think. Once everything is healed and you get your muscles back in shape, you'll be able to do pretty much everything someone our age is likely to do…unless you are playing to take up gymnastics? I dance, do yoga, scrub floors, climb ladders, garden, ride a bike…

"Oh well, I guess I'm a worry wart." But look – you've almost gotten to the finish line! And you have all the information you need to make it work.

Have you got all your props in place for after surgery – lots of ice packs, reacher, chair, easy food, help?

You've got it Cindi!
Sue

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@birdman518

Once you make up your mind, the beauty of anesthesia is that you wake up and it's over. For me, my left hip replacement was a non-issue for me after it was done.
I wish you the best!

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Thank you. Well, here is the news. The doctor dismissed me in anger today because I dared tell him something about his eye. He got very angry and said I was accusing him of not being able to see properly. I never said that, actually I was unfortunately just trying to be friendly. His eye was red and I thought something was wrong. He got very upset and told me to find another doctor. ๐Ÿ™‚ I will. In the meantime, I'm glad to have a relief from the pressure of getting it done. He told me before he dismissed me (threw me out) that the recovery would be very rough. I didn't object, in fact I told him I trusted him as a surgeon. Oh well, he didn't like the fact that I mentioned something about his eye. I was concerned. I'm smiling while I say this. ๐Ÿ™‚

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@sueinmn

"The big problem that frightens me (although I am working on putting trust in my surgeon) is the position I'll be in during the surgery โ€” I saw pictures on the internet about that and it looks formidable. " Well, Cindi, that's why they put you to sleep before they wrangle you into position, and lay you on your back before they wake you up! You'll never even know.

"I'm also concerned about restrictions in my movement after the surgery for the rest of my life if I don't dislocate the ball and joint. " Well, the restrictions are not nearly so bad as you think. Once everything is healed and you get your muscles back in shape, you'll be able to do pretty much everything someone our age is likely to do…unless you are playing to take up gymnastics? I dance, do yoga, scrub floors, climb ladders, garden, ride a bike…

"Oh well, I guess I'm a worry wart." But look – you've almost gotten to the finish line! And you have all the information you need to make it work.

Have you got all your props in place for after surgery – lots of ice packs, reacher, chair, easy food, help?

You've got it Cindi!
Sue

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Well, I hope you read what happened today when I went to the surgeon to firm up what was going to happen. He threw me out. haha, I have to laugh. I guess he was very touchy. TTYL and keep you informed. I'll be looking for another doctor in the meantime. ๐Ÿ™‚

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