Anterior Hip Replacement: Why Consider It?

Anterior hip replacement is one of the newest advances in hip replacement surgery. Incredibly safe and effective, this procedure like many of the recent advancements in total hip replacement involves a quicker route to rehabilitation. At OrthoNebraska, we believe patients should be out of bed within two hours of surgery and home as quickly as possible. Research has shown that sending people home results in higher patient satisfaction and lower infection rates.

The posterior approach involves an incision along the buttocks. It has been the traditional surgical method for total hip replacements for many years, and involves accessing the hip joint by cutting the buttocks muscle. It is a very safe and effective approach with years of good clinical results.

More recently, the anterior approach has emerged as a minimally-invasive option for total hip replacement. It involves a small, four-inch incision along the front leg. It offers a more direct approach to the hip joint, as muscles are separated rather than cut, leaving them more or less intact. I was able to perfect the nuances of this approach during a one-year fellowship.

I prefer to use this minimally-invasive approach whenever I am sure it will give my patients the best outcome for the following reasons:

  • Less Major Muscle Damage: By preserving the muscles, this study suggests there is less tissue damage and subsequent pain
  • Low Risk of Hip Dislocation: Dislocation can occur with any surgical approach. However, by leaving the surrounding soft tissue intact, your total hip replacement is stable with a very low risk for dislocation, according to many studies
  • Accelerated Recovery: You will be walking within hours after surgery. Research has shown patients undergoing direct anterior hip replacements require usage of fewer pain medications and are discontinuing any walking aids at a significantly faster rate. The goal will be to allow you to return to your preferred activities faster.
  • No precautions: Studies have shown that hip precautions and motion restrictions after a direct anterior total hip arthroplasty are not necessary.

Of course, with any surgery, there are risks of complications. Specific to this procedure, those include thigh numbness and fractures. The lateral femoral cutaneous nerve is a sensation-only skin nerve that normally runs down the middle of the thigh. Rarely, this nerve can get irritated and injured resulting in temporary numbness and/or burning across the outside of the thigh. Research confirms that the vast majority of these cases are self-limited and resolve on their own without any complications. There is a small risk for fracture during surgery, particularly if you have osteoporosis. A highly specialized table and careful surgical technique helps minimize that risk.

When discussing surgical approaches, we will always proceed with the safest and most effective approach to give our patients the best outcome.

OrthoNebraska is a high-volume facility for joint replacement, with lower complication rates than most other hospitals in the area. To make an appointment with me, you can call (402) 609-3000.

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