Anterior HR

[stephen1254]

From what I read on this site this is a sensitive subject, but since this site is all about information I wanted to relate my recent experience.

My right hip was resurfaced 2.5 years ago by Dr. Callendar in San Francisco, using a posterior approach. Recovery was fairly quick and, to date, I have no complaints.

My left hip was done 3 weeks ago by Dr. Raterman in Tampa. He offered me the option of an anterior approach, which I took, as it offered a slightly quicker recovery. He explained that he can only do the anterior approach for certain patients. The criteria was a reasonably large bone structure, muscular but not too muscular, and fairly lean. I'm certain that evaluation is done on a patient by patient approach.

The surgery went fine. I transitioned from a walker to a cane as soon as I got home, and went off the cane at 7 days post op. I was on an exercise bike at 10 days post op, and on my bicycle at 11 days post op. The 90 degree restriction was lifted at 14 days. The range of motion increases, and the pain decreases, daily.

The best way I can think off to describe the recovery is that it was like starting at day 8 on my recovery from the other hip. I was able to sleep in my bed immediately, where I slept in a chair for 8 days before. I was off the walking aids about a week sooner, and on my bicycle about a week sooner.

There are no real negatives that I can report. The skin over my quad is a little sensitive, and the amount of feeling when I touch the skin is ever so slightly less than the other leg, although it is still early days. While waiting for the doctor at the 2 week followup I studied the x-ray showing both of my hips at length. As closely as I can tell, the angle of the cap to the cup is the same, the pin from the cap is inserted at exactly the same place in the femur and at exactly the same angle. The doctor said the x-ray looked terrific.

This is just my experience and YMMV.

[Dannywayoflife]

Fair play to you. To be honest personally if I was seeing one of the top surgeons  I'd just let them do what they feel is right. They are the experts

[Pat Walter]

Thank You for your post.  It is great to hear all different ways of surgical approaches and devices.

It is an excellent comparison since you had both approaches. 

I have not ever said the anterior approach is wrong or bad, it is just another way of doing a THR or BHR.  There can be nerve problems if a surgeon is not really experienced.  Same rule as choosing a surgeon.  Pick a surgeon that does a lot of surgeries via anterior approach and you should not have any problems.

Thanks again.  Will look forward to your future posts.  Good Luck.

Pat

[HowieF-16]

I think the lesson here is that you worked closely with your surgeon to determine what was best for you. I have always believed we are equal partners in this process. Dr. Raterman was my surgeon and I was very impressed with his entire team and as I approach one year post-op, I couldn't be happier.

[demens13]

Just stating to talk to docs so only have 1 opinion to report back on this.

Alexander Mclawhorn from HSS said posterior only. He says Dr Su does posterior only. Given that HR are not done with robotics, it's important to have better access to the area for placement and this is better with a posterior approach. Mclawhorn using anterior for THR, his take is that for THR the anterior muscle sparring method is beneficial and provides better stability and lowers dislocation chances. For HR the dislocation risk is lowered by using larger components so at least one of the benefits of anterior is not a big factor. He also said he's seen some results of anterior HRs and it was not pretty.

I've read a bunch of posts here about success with anterior HR, details about recovery, etc, but i think they all miss the point. The success or failure of this is determined over time. If the component isn't placed perfectly leading to some friction resulting in metal ions, you might not see this for years.