Emma Hayes, a physiotherapist and fellow blogger at MYTRAVELBUGBITE, brought up some important points about my post “Tips For Those That Need a Hip Replacement”. I didn’t want this to get lost in the comments so I will revise the post. For those of you that read it already, the first issue is that in talking about the anterior vs posterior approach to hip replacement surgery, I did not point out all the cons to the anterior approach. In Emma’s words, “Many surgeons don’t do anterior incisions because it is a much higher risk surgery, there are far more important vessels and tracts running close to where the anterior incision site is”.
I definitely would not want to have the anterior approach done unless the surgeon is very experienced at it. My surgeon has done thousands of the anterior procedures without problems, is well aware of the risks, and knows how to avoid them. He discussed these with me in our consult. Sorry, but that was seven years ago so I forgot this important detail in the original post. There is another con I should have mentioned about the anterior approach. There are also more small nerves in the front of the leg than the back, which unavoidably get cut during the procedure. This can lead to some nerve pain or numbness in the weeks post-op, which my surgeon warned me about but told me it is temporary until the nerves heal. He precribed the drug Neurontin (Gabapentin) in the first few weeks to address this. I did not experience any pain but did have some minor numbness, which went away after a couple of months.
So there is a definite trade-off between the two approaches. I think the most important thing is to go with what your surgeon says, especially if it is a surgeon you are confident in and have a good rapport with after the consult. If you are just starting your search for a surgeon I think it’s helpful to know there are two different approaches to the surgery and see what your surgeon’s opinion is.
The other thing Emma pointed out was I had specifically mentioned the clamshell exercise as one of the post-op PT exercises. That is only true for the anterior approach, for the posterior surgery the clamshell is avoided post-op. My point was to do whatever exercises your PT (or physio if your in the UK) gives you diligently, but the clamshell was not a good example to pick because it is not universal.
Thanks for the feedback Emma!