Anterior Approach Total Hip Replacement

Over 80% of our hip replacements are performed using the advanced minimally invasive anterior approach. An anterior hip replacement is muscle-sparing allowing for a potentially faster recovery rate and enhanced patient outcome after surgery

What is an “anterior” hip replacement?

posterior approach hip replacement“Anterior” refers to the surgeon’s approach to the hip (which side we will enter the hip joint). There are 4 approaches to perform a hip replacement:

1. Posterior (from the back of the hip)

2. Lateral (from the side of the hip)

3. Anterolateral (half way between the lateral and anterior)conventional hip replacement

4. Anterior (from the front of the hip)

All approaches have been shown to allow excellent access to the hip joint to successfully implant the devices necessary for hip replacement. The majority of our hip replacements are performed through an Anterior Approach.

anterior approach hip replacementAnterior Hip Replacement Advantages:

  • Less invasive and muscle sparing
  • Decreased dislocation potential
  • Live x-ray ensures accurate sizing and placement of components

Less Invasive and Muscle Sparing

The anterior approach is a single small incision, muscle sparing total hip replacement approach. Even the “mini-posterior” approach requires some splitting of the gluteus maximus muscle. With the anterior approach, your surgeon can work between your muscles and tissues without detaching them from the hip or thigh bones.

Decreased Dislocation Potential

Generally an anterior approach is inherently more stable than a posterior approach. A recent study in the Journal of Bone and Joint Surgery reported that the most common reason for revision (redo) of a hip replacement is for dislocation (where the ball pops out of the socket requiring a physician to put it back in place). In general, dislocations are almost always in a posterior direction. A posterior approach requires entering and cutting through the posterior lining of the hip potentially weakening this region and allowing for the hip to dislocate. Although experienced hip surgeons may have a very low dislocation rate with a posterior approach, an anterior approach avoids violating the posterior structures altogether. This potentially allows for a lower dislocation risk. In fact, our patients are not given any “hip precautions” (restrictions of certain positions) following an anterior approach allowing for more straightforward and potentially faster recovery.

Live Xray (Flouroscopy)

The anterior technique also calls for use of a live mobile x-ray (fluoroscope) during the procedure. This device enables your surgeon to not only visualize the components by direct vision, but also visualize the hip replacement with an x-ray to ensure that appropriate sizing and position of all components has been achieved.
The fluoroscope also allows your surgeon to compare one hip to another with increased ability to measure for correct limb lengths. One of the most common problems we encounter in hip replacement is limb length inequality. Although not foolproof, an intraoperative live xray comparison before the surgery is completed enhances the accuracy of this measurement.

Can both hips be done at the same time?

Yes. If it is determined that both hips would benefit from total hip replacement surgery, both can be done in the same setting. Patients may weight bear as tolerated immediately after the procedure on both legs. This is called Bilateral Total Hip Replacement.

Hip Pain Treatment

anterior approach hip replacement

Over 80% of our hip replacements are performed using the advanced minimally invasive anterior approach. An anterior hip replacement is muscle-sparing allowing for a potentially faster recovery rate and enhanced patient outcome after surgery… (read more)

total hip replacement

Total hip replacement is a procedure performed for severe arthritis or other degenerative condition of the hip joint. It is called a total hip replacement because both the ball and the socket of your hip are resurfaced… (read more)

hip resurfacing

Hip Resurfacing is intended for young, active adults in need of a hip replacement. This conservative treatment resurfaces rather than replaces the end of your femur bone with an implant that is potentially more stable… (read more)

bilateral hip replacement

Having both hips replaced on the same day is called “bilateral” hip replacement surgery. For qualified candidates, bilateral replacement means not having to undergo surgery and postoperative rehabilitation twice… (read more)

revision hip replacement

Joint replacement is one of the most common and successful procedures performed by orthopaedic surgeons, but not every procedure is successful. The goals of a joint replacement are to decrease or eliminate pain from an arthritic joint and improve mobility/joint function. Evaluation is warranted when a joint replacement is not achieving reducing or eliminating pain at the joint… (read more)