Anterior Hip Replacement

Anterior hip replacement is a technique to replace worn ends of the bones in the hip joint.  Anterior hip replacement differs from a later or posterior hip replacement procedure in that it requires a minimal incision in the front of the hip. The surgeon then accesses the damaged joint through the natural spaces between the muscles and tendons. For some patients, recovery from this approach is quicker and less painful than from surgeries using other approaches that require the muscles and surrounding soft tissue to be surgically detached.

Is it right for you?

Anterior hip replacement is not appropriate for all patients and, as with any surgery, has it own risks.  Ideal candidates for this procedure are slender in build and motivated to follow a pre- and post-operative conditioning program.  This procedure is not recommended for people with brittle bones or those who are obese or extremely muscular because the excess soft tissue decreases the space in the front of the hip.

Some patients may be good candidates for a same day outpatient anterior hip procedure, which allows them to begin recovery in the comfort and safety of home.  Read the comprehensive  Outpatient Hip Replacement Surgery brochure to learn if this option is right for you.

Benefits

In other hip replacement procedures, surgeons replace the damaged hip cartilage and bone with a prosthesis through an incision in the back (posterior) or the side (lateral) of the hip. In both of these procedures, surrounding muscles need to be cut or detached from the bone to provide access to the joint and then repaired at the end of the procedure.  With anterior hip replacement surgery, the front of the hip has fewer and smaller muscles, enabling surgeons to use a small incision and work through the spaces between them.

Since anterior hip replacement surgery does not disrupt the surrounding muscles or soft tissues, patients have fewer post-operative restrictions  are often able to go home on the same day of the procedure. Patients are typically walking with crutches or a walker on the same day as the procedure and usually are able to walk unassisted  5 – 7 days earlier than patients who have had a procedure using the lateral or posterior approach.

Limits and Risks

Any successful hip replacement surgery depends on many factors beyond surgical approach, including the surgeon’s training and skill, the patient’s overall health and fitness, and the patient’s level of commitment to pre-surgical conditioning and post-surgical rehabilitation.

The anterior hip replacement procedure requires a high level of training and precision because surgeons are working with a restricted view of the hip joint. With the anterior approach, the surgical area is near the lateral cutaneous femoral nerve, which extends from the front of the pelvis to provide sensation to the outer thigh. If the nerve is affected during surgery, the thigh could become numb and, in rare cases, (less than 1 %) patients develop a painful skin condition.

Not every hip replacement surgeon has undergone the highly technical training to safely to perform the anterior procedure, so it is important investigate the qualifications of your surgeon before scheduling surgery.

Individuals considering hip replacement surgery should consult with a hip replacement specialist to understand which approach is best suited for his or her personal circumstances and lifestyle goals.

The video below demonstrates the procedure. Surgeries may vary based on a patient’s individual condition.

DePuy – What to expect Before, During and After Anterior Hip Replacement

Total Hip Replacement overview by American Association of Orthopaedic Surgeons (AAOS)