HELP! Anterior vs. Posterior Approach

[MelissaMartin]

I need to make a decision regarding the two types of incision approaches...today or tomorrow.  This would delay my surgery for 12 days, no biggie, but I am getting mixed input on the two approaches after reading posts.

Is there any more clarification on this topic?

Melissa Martin
L BHR Ure 10/10 (posterior) or 10/22 (anterior)

[Pat Walter]

Hi

Most of the experienced surgeons only use the posterior approach. You can read why here
http://www.surfacehippy.info/surgicalapproaches.php  If you already had the posterior approach - why is Dr. Ure going to change now???  He must have a good reason.  From what I have read by the experienced docs, like mine Dr. De Smet and Dr. Bose, they all prefer the posterior.  They feel there are too many things that can go wrong with the anterior.  Yet some docs use the anterior.

I think only you and your doctor can figure this one out.  You need to ask him why he wants to change to the anterior.  What are the risks with real percentages of what can go wrong.  What is better about it than the posterior.  Why he wants to change now.

I always tell people to trust their doctors, but their doctors have to be willing to talk to them.  You need to know the odds of what can go wrong and why before you accept a different approach.  He must feel very secure about it.

It does seem strange to change now.  Did you have a fast and easy recovery from your first resurf? I would tend to want to stay with what worked if all went well. I had a very quick and easy recovery with my De Smet posterior approach. On one crutch at 4 days and none at 4 weeks. No swelling or brusing and no pain meds required after leaving the hospital.  If your recovery was good, why change in mid stream now?  Of course, if you had problems, it might be a different thing.

Let us know what you decide and why.  It will be very educational to know why he is changing.

Pat in Ohio
3/15/06 LBHR De Smet

[Vicky]

Melissa,

Are you requesting that the doc use anterior?  Or is Dr. Ure telling you that he wants to use the anterior approach?  More muscles are cut with the anterior approach, also there is more risk of nerve damage as well as formation of heterotopic bone growth.  The latter is the reason that McMinn who invented the BHR switched to using only posterior. 

One reason that the docs that use anterior approach "claim" is that it preserves the blood supply to the head of the femur better.  But, when you take a look at all of the success that the majority of the top docs using the posterior approach have, there is absolutely NO reason to suspect that this is even significant.  I personally would only choose the posterior approach and not add to my recovery with more muscles to have to rehab if I had the anterior approach.

Vicky