Anterior Hip Replacement

Total hip replacement is a common surgical solution used to treat chronic hip joint pain and debilitating conditions affecting the hip. However, there is some debate over which approach provides optimal results — posterior hip replacement, which is most commonly performed, or anterior hip replacement.

Today, more and more orthopedic surgeons offer anterior hip replacement surgery, as it provides the same results with less disruption to the surrounding soft tissues and muscles. The hope is that this minimal disturbance during the operation will allow patients to experience less pain and a faster recovery.

If you require a total hip replacement, you should know that the surgeons at OrthoBethesda have the specialized training and equipment necessary to conduct anterior hip replacement successfully. When you meet with our team, they’ll discuss whether the posterior or anterior approach is the best choice for your individual circumstances.

Differences Between Posterior and Anterior Hip Replacement Surgery

Total hip replacement using an anterior approach is not a new procedure — in fact, it was developed more than 50 years ago. Despite this fact, it’s estimated that only 15 to 20 percent of hip replacement surgeries utilize the anterior approach. However, that doesn’t mean this method is inferior in any way.

As orthopedic surgeons strive to provide patients with an overall positive surgical experience, anterior hip replacement surgery is starting to become more common. The only factors that affect why the posterior approach remains more popular are that special training and equipment are generally necessary to successfully perform anterior hip replacement surgery. Also, many surgeons believe posterior hip replacement provides them better visibility of the hip joint during the operation.

Both anterior and posterior hip replacement procedures have the same objective — to remove the damaged head of the femur and any damaged cartilage from the hip’s socket. However, there are distinct differences between the two approaches:

• Point of entry: During posterior hip replacement surgery, your surgeon makes an incision either on the back of your hip or on the side, usually about 10 to 12 inches in length. The incision is on the front of your hip for the anterior approach, and it’s only about four to five inches long.
• Muscle detachment: Posterior hip replacement requires the surgeon to cut through major muscles to access your hip. However, there are fewer muscles found in the front of an individual’s hip, so the surgeon can work through these as opposed to cutting through them.
• Hospitalization: With the anterior approach to hip replacement, you can return home within two to four days, as opposed to the three to 10-day hospitalization required after posterior hip replacement.
• Recovery: Recovery time is longer when the posterior technique is used since it involves cut muscles, generally taking about two to four months. The less invasive anterior approach will allow your recovery time to be reduced to two to eight weeks.

Your Anterior Hip Replacement Surgery

Anterior hip replacement surgery takes a few hours. General anesthesia ensures you sleep throughout your operation, and your vitals are closely monitored during the procedure, including your heart rate and blood pressure. In general, an anterior approach hip replacement follows these steps:

• The skin around the hip’s surgical site is cleaned, and hair is removed if necessary.
• Your surgeon makes an incision in front of your hip joint.
• Muscles are separated to provide your surgeon with visibility of your hip joint.
• The upper part of your femur is removed along with damaged cartilage and bone from your pelvis.
• An artificial joint replaces the hip bone’s socket as well as the head, neck and part of the shaft of the femur.
• The incision is closed up once your surgeon ensures that the new joint is placed properly.

Potential Risks of Total Hip Replacement With Anterior Approach

Although the anterior approach hip replacement is relatively safe, as with any surgery, there are potential risks, including:

• Bleeding
• Infection
• Blood clots
• Nerve injury
• Joint loosening
• Hip joint dislocation
• Changes to your leg’s length

There’s also a chance that your surgery will not resolve your hip joint pain or improve your overall mobility. Very rarely, patients develop new pain or experience decreased mobility after their surgery. Your surgeon at OrthoBethesda will discuss all potential risks and concerns with you before pursuing an anterior hip replacement.

The medical world is currently revisiting what makes a successful hip replacement procedure. Many believe the anterior approach is a better method. That said, the anterior hip replacement is not for everyone.

When you schedule your appointment at OrthoBethesda in Bethesda, Maryland, your surgeon will discuss potential treatments for your hip joint issues. We generally recommend conservative treatment options first and foremost. However, if you require anterior hip replacement surgery, we have the skills necessary to ensure a successful outcome.

Further Reading

Anterior vs. Posterior Hip Replacement

How to Sleep After Total Hip Replacement Surgery