I would Benefit from the Anterior Approach

[Pat Walter]

hello pat,

i have read all dr. bose and de smet and others articles about
the approaches used with  BHR. I have located a surgeon that says he can do either approach but that i  would benefit from the anterior approach. I am also having bilat. done within the same procedure.

(the doctor)  he states anterior will allow more stability resulting in higher activity levels for me. this contradicts all the articles i've read regarding approach used. apparently most surgeon are approaching posteriorly. can you shed some light on this for me? this issue seems  worrisome to me. would you say i am worrying about needlessly??? should i just trust the surgeon?

thank you--F

[Pat Walter]

Hi F

I am not much of a medical expert.  After doing all the reading that I did,
I felt the posterior approach seemed better since it was safer to my
reasoning.  I think that is why so many doctors use it.

I have a handful of articles about the posterior vs anterior approach on this page
http://www.surfacehippy.info/surgicalapproaches.php

Who is your doctor?  How many hip resurfacings have they done?

I realize anterior lets you bend forward without the 90 degree rule, but
there is more of a possiblity of nerve damage from what I read.  If your
doctor is well experieinced in hip resurfacing and wants to use that
approach, I guess you will have to go with it.

Personally, I would stick with a surgeon who had done a whole lot of hip
resurfacings if I were to be a bilat - and normally those doctors use the
posterior approach.

I think it really depends on your own confidence in the surgeon. I am old
fashioned and nothing less than a De Smet or Bose would do for me since they
have so much experience.  I would be very leary of using the newer surgeons.
But that is just my feelings.  I know that the hip resurfacing is almost as
much of an art as a science and the ball on the femur has to be placed just
right.  I will say that there seems to be a lot more problems with people
using the newer doctors.  There was the recent revision for the lady at 8
months.  There was the lady with the slipped acetabular cup and had to have
her 3rd revision.  There has been a lot more swelling, pain and problems as
I read about the newer people using the newer doctors.

I can only go by my own experience.  All the De Smet patients usually have
very few problems and no swelling.  The bi lats have a little more difficult
time.  I imagine you have been reading about Michelle and the other fellow
that recently had their bi lats done with De Smet.

If you are not worried and don't have nagging thoughts about the surgeon and
his/her approach  - then go with it.  If you seem to be questioning it too
much in your own mind - then I would listen to that message and look for
another doctor.  I always have found in my 62 years that I listen to my own
thoughts and I usually don't go wrong.  If you are completely comfortable
with it - go for it.  If you have nagging questions and don't feel
comfortable - look for another surgeon.

This is very serious and important surgery.  You whole future, active life
depends on it.  You only have 2 hips and you don't get many chances to
operate on them.

I don't know if that helped you at all.   I am just old fashioned and like
very experienced people doing very serious procedures to me.

Pat

[Vicky]

Personally I would never have an anterior approach.  From what I understand it benefits the surgeon since it is easier for him and makes for a nmuch more difficult recovery for the patient.  The posterior approach is the muscle sparing approach and the patient returns to normal activities a lot sooner than when they get the anterior approach at least from what I understand.  Basically the big muscles are cut with the anterior approach (the ones that move the hip sideways) and it takes a lot more work to get those back into shape.  Who is your doctor?  Most of the top docs that I know of use the posterior approach.  Mr. McMinn who is one of the inventors of the BHR device found that there was a higher occurence of ectopic bone formation using the anterior approach and he switched to using the posterior only. 

Vicky