Hip Resurfacing in June Anterior Approach

DRBIRD · April 13, 2009, 06:19:05 AM

I WILL BE HAVING HIP RESURFACING IN JUNE USING THE TRUE ANTERIOR APPROACH WITH THE SMITH PETERSON TABLE. WATCHING THE ANIMATION ON 'YOU TUBE' FROM DR KREUZER IN HOUSTON, SHOWS THIS TO BE THE MUSCLE SPARING APPROACH. THE MUSCLES ARE RETRACTED AND NOT CUT AS IN THE POSTERIOR AND ANTERIOR LATERAL APPROACHES. THERE IS A SLIGHT POSSIBILITY THAT THE CUTANEOUS NEVE MAY BE DAMAGED BUT THIS WOULD ONLY AFFECT SENSATION OVER THE HIP AND NOT FUNCTION.
I THINK MOST SURGEONS ARE USED TO THE OTHER APPROACHES BUT HEALING AND RECOVERY SHOULD BE BETTER AND FASTER..
GREAT SITE. VERY WELL ORGANIZED.

Pat Walter · April 13, 2009, 01:01:43 PM

Hi
You did not see your topic because you made a response to my topic about how to post on Hip Talk.

I moved it so you had your own topic here.

You might get some replies about your surgical approach choice, but few people have had the anterior or anterior lateral approach who post here. That doesn't mean it is not a good choice, just most of the really experienced surgeons still use the posterior approach. That might be changing in the future since trends seem to change in hip resurfacing.

Please realize that your recovery may or may not be faster than anyone's with the posterior apporach. I had the posterior approach and had a really quick and easy recovery with Dr. De Smet of Belgium. He has done over 3000 resurfaicngs. I was in the hospital 2 1/2 days, then at the Holiday Inn. I ate every meal out after leaving the hospital and took nothing but Advil. I had no great pain, swelling or bruising,. That is due to De Smet's surgical technique. I was on one crutch at 4 days and none at 4 weeks. I was sight seeing by 5 days post op and walking 1 mile a day by 13 days post op. I could have stopped using my crutch at 3 weeks, but thought I should use it a bit longer.

So size of incision and approach is not always the detrmining factor in quick and easy recoveries. It is a great deal the surgeon's skill and each person's body. There is never a way to predetermine what kind of recovery you will have. You can't base it on anyone else's recovery. You are unique and your recovery will be unique.

I look forward to hearing about your experience and posting your story for you after your surgery. We all always want to learn more about hip resurfacing surgeons and surgical techniques.

Good Luck.

Pat

DRBIRD · April 13, 2009, 04:05:02 PM

PAT
THANKS FOR YOUR PROMPT REPLY. THE SURGEON I'M USING HAS BEEN DOING THPS WITH THE DIRECT ANTERIOR APPROACH FOR MANY YEARS AND HAS TAUGHT THIS TECHNIQUE NATIONALLY. HE HAS NOT DONE MANY HIP RESURFACINGS, HOWEVER I'M CONFIDENT IN HIS ABILITY FROM HIS CREDENTIALS AND THE SURGEONS HE HAS LEARNED THE TECHNIQUE FROM. I DO NOT KNOW IF HE WANTS HIS NAME MENTIONED . SO I DIDN'T AT THIS TIME.
BUT AGAIN, RETRACTING MUSCLES OUT OF THE WAY IS DEFINITLEY LESS INVASIVE THAN CUTTING THEM.
THANKS AGAIN

B.I.L.L. · April 15, 2009, 12:05:42 AM

Quote from: DRBIRD on April 13, 2009, 04:05:02 PM
PAT
THANKS FOR YOUR PROMPT REPLY. THE SURGEON I'M USING HAS BEEN DOING THPS WITH THE DIRECT ANTERIOR APPROACH FOR MANY YEARS AND HAS TAUGHT THIS TECHNIQUE NATIONALLY. HE HAS NOT DONE MANY HIP RESURFACINGS, HOWEVER I'M CONFIDENT IN HIS ABILITY FROM HIS CREDENTIALS AND THE SURGEONS HE HAS LEARNED THE TECHNIQUE FROM. I DO NOT KNOW IF HE WANTS HIS NAME MENTIONED . SO I DIDN'T AT THIS TIME.
BUT AGAIN, RETRACTING MUSCLES OUT OF THE WAY IS DEFINITLEY LESS INVASIVE THAN CUTTING THEM.
THANKS AGAIN

I don't know a whole lot about the different ways to gain access to the end of your femur and expose the pelvis, but if he hasn't done alot of re-surfacings I would recommend grilling him a little bit about cup angles and ball size and placement etc. Ask him how he aligns the cup, does he eyeball it ? What angle does he shoot for? Does he use an instument to check it ? What about the femoral head ? What size is it and how does he line up the drill etc. ? Cemented or not ? Does he have any re-surfaced patients he's done that you can talk to ? I don't mean to sound too skeptical and don't take this the wrong way but getting in there is only part of the deal, make sure he knows how to place the componets, I know he has done lots of THR's but re-surfacing is a different animal. I'm not trying to take any wind out of your sails I'm really not, I truly hope you have a flawless surgery that lasts a lifetime, but there is a learning curve for re-surfacing. Make sure he is as anal about placing the componets as he is about gaining access. I don't want to sound discouraging, but the Dr. who did mine had done lots of THR's and my componets are placed...well lets just say less than perfect, and you want them perfect. Please don't take this post the wrong way, I just don't want anyone to go through what I have. Get educated and ask lots of questions, proper placement is the key to a long lasting normal feeling hip !! Just my $.02
Good luck and keep us posted. Bill