The Anterior Approach to Hip Replacement Surgery
Over the years, the anterior approach to hip replacement has revolutionized hip replacement surgery. Its key characteristic is the use of specialized techniques and instrumentation that allows the physician to perform this major surgery with less pain, faster recovery and improved mobility.
The anterior approach for minimally invasive hip replacement is a muscle-sparing alternative to traditional hip replacement surgery that allows the surgeon to work between muscles and tissues without detaching them from either the hip or thighbones – sparing the tissue from trauma. Keeping the muscles intact also helps prevent dislocations. Anterior procedures and surgical instruments are advanced and high-tech, improving access to the hip and achieving excellent alignment and positioning.
Anterior vs. Traditional Hip Replacement
The Anterior Approach is a minimally invasive technique used in hip replacement surgery. Continuing orthopaedic experience suggests that this procedure may offer several advantages over the more traditional surgical approaches to hip replacement, such as a smaller incision, reduced postoperative pain, and faster recovery and rehabilitation.
The Anterior Approach differs in many ways from traditional surgery techniques. Traditional hip replacement techniques involve operating from the side (lateral) or the back (posterior) of the hip, which requires a significant disturbance of the joint and connecting tissues and an incision approximately 8-12 inches long. In comparison, the anterior approach allows the surgeon to use one small incision on the front (anterior) of your hip, helping to avoid the pain of sitting on the incision site.
The hip is exposed in a way that does not detach muscles or tendons from the bone. A high-tech operating table is used to help improve access. Intraoperative x-ray is typically used to confirm implant positioning and leg length. The Anterior Approach enters the body closer the hip joint with far less tissue between the skin and the bones of the hip, so more patients, including larger, heavier ones, maybe candidates for MIS hip surgery using this technique.
There is also the potential for rehabilitation to be quicker and hospital stays to be shorter because the hip is replaced with minimized detachment of the muscles from the pelvis or femur. The smaller incision and reduced muscle disruption mean that patients may also have a shorter recovery time and less scarring, as well as a shorter post operative limp period. With this approach and the minimization of the tissue damage, there may also be less blood loss and reduced post operative pain.
Traditional hip replacement techniques also require patients to take special precautions to prevent dislocation of the prosthesis, like not crossing your legs, not bending your hips more than a right angle, not turning your feet excessively inward or outward and using a pillow between your legs at night when sleeping.
Following the anterior approach, the risk of dislocation may be reduced due to more stability of the implant. Under doctor supervision, patients may be immediately allowed to freely bend their hip and even bear their full weight onto their hip immediately or soon after surgery. Using the latest technology, the anterior approach takes advantage of a special operating table that rotates the hip outward to expose the joint making the access to the hip easier to achieve.
Typically, the hospital recovery time for anterior hip replacement is one to three days, where you will work with a therapist to strengthen yourself for your return home. Recovery can still take up to two to three months, an improvement from typical hip replacement which can take up to six months.
Hip replacement, no matter how minimally invasive, is a major surgery, and patients are at risk for complications. However, the complication rate following joint replacement surgery is low. Serious complications, such as joint infection occur in less than 2% of patients.
Although the anterior approach may make sense for some patients, only your surgeon can help you decide what is best for you. Talk to J. Lex Kenerly, M.D., Orthopaedic Surgeon, and the staff at the Bone & Joint Institute of South Georgia if you have questions about the anterior approach for total hip replacement or joint replacement in general.