Anterior Hip Replacement

Is Anterior Hip Replacement Right for You?anterior hip joint replacement

Anterior hip replacement offers many advantages over traditional hip replacement procedures; however, it is not for everyone and, as with any surgery, has its own risks.

Advantages of Anterior Hip Replacement

In traditional 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.  The front of the hip has fewer and smaller muscles, enabling surgeons to work between them.  Therefore, patients typically experience less post-surgical pain and don’t require as much pain medication.

Since anterior hip replacement surgery does not disrupt the surrounding muscles or soft tissues, the risk of hip dislocation, a major concern with hip joint replacement, is greatly reduced.  Patients can bend at the waist and sit with their legs crossed as soon as it is comfortable; traditional hip replacement patients must avoid those activities for 6 – 8 weeks or longer because of the risk of dislocation.

Patients who have undergone anterior hip replacement are often able to go home the day of the procedure because they tend to recover more quickly than with the other approaches. Patients are typically walking with crutches or a walker and are able to bend at the waist within a day, and are able to walk unassisted a week or more earlier than patients who’ve had one of the traditional procedures.

Limits and Risks of Anterior Hip Replacement

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 post-surgical rehabilitation. In general, people who are obese or extremely muscular are not good candidates for anterior hip replacement because the excess soft tissue decreases the space in the front of the hip.

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 %) 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.

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.

Watch a video demonstration of the procedure.

Schedule a consultation with with a hip joint replacement specialist or call for an appointment 203-869-1145.

ONS In The Lead with New Hip Replacement Procedure

ONS hip and knee replacement specialist Dr. Jonathan Berliner was featured in the Daily Voice for his expertise in anterior hip replacement, a relatively new approach to the procedure.

In the online article, titled, ONS Remains at the Forefront of Hip Replacement Surgery, John Haffey writes:

“Faster recovery and less pain are just a few of the reasons why minimally invasive anterior hip replacement surgery has seen an increase in popularity in recent years. However, this intricate procedure requires a high degree of training and expertise, and not all joint replacement surgeons are qualified to perform the operation.

During more traditional approaches to hip surgery, surgeons cut and remove the damaged cartilage and bone, and replace it with a prosthesis through an incision in the back (posterior) or the side (lateral) of the hip, explained Dr. Jonathan Berliner, a joint replacement specialist at Orthopaedic & Neurosurgery Specialists who performs the minimally-invasive surgery. During these procedures, muscles need to be cut or detached to gain access to the surgical area. However, through the anterior approach surgeons can enter through the hip’s front and repair the joint through the natural gaps between muscles. This precision helps minimize injury to the soft tissue in the area.

“Since there is less disruption to the muscles and tendons, patients tend to recover hip function and gait mechanics more quickly and with less pain,” said Berliner. The risk of hip dislocation, a concern after total hip replacement surgeries, is decreased because the muscles and soft tissue structures that normally hold the hip joint in place remain intact. Patient hospital stays are also generally shorter with the anterior approach.

Surgeons have been using an anterior approach to other hip surgeries for some time, but anterior hip replacement has only recently gained increased attention, noted Berliner. It’s estimated that only 15 to 20 percent of hip replacement surgeries performed in the United States utilize this approach. Moreover, not all joint replacement surgeons have undergone the specialized training required to perform this technically challenging procedure, which offers a limited view of the operating site and leaves little room for error.”

The Daily Voice shares its content across Fairfield and Westchester counties.  You can read other ONS related stories that have appeared in the Daily Voice here.

Hip Impingement


Suffering From Hip Pain? ONS Dr. Tim Greene Explains It May Not Be Arthritis

Acute hip pain can derail even the most active athletes, and is often attributed to arthritis. However, hip impingement, also known as femoroacetabular impingement, can cause significant groin pain during everything from playing sports to daily tasks.

“The symptoms of impingement are most commonly pain the groin or front of the hip,” said Dr. Tim Greene, an orthopedic surgeon at ONS in Greenwich. “This pain generally increases with more activities. The more active you are the more pain seems to flair.”

Hip impingement tends to occur in active young adults, especially athletes. A painful and often unrecognized condition, impingement involves a tear in an athlete’s labrum. The problem can stem from various causes, including an imperfect shape of the ball and hip socket, which can pinch the hip labrum and cartilage causing damage with rotational movements of the hip.

“An MRI with contrast is one of our best tool at this point to diagnose injuries of the labrum cartilage,” said Greene.

However, due to the microscopic nature of some labrum tears, an arthroscopic procedure with a small camera may be needed for a complete diagnosis and repair. “We’ve developed tools that can be used inside the hip in a minimally invasive fashion, and able to treat labrum tears easily,” he said.

Prior to the minimally invasive procedures, hip impingement was treated with open surgery, resulting in a lengthy recovery time. Now, the condition can be corrected using a camera and a few small incisions. This allows for shorter recovery and a quicker return to sporting activities.

“We have learned over the course of time that you have to treat not only the symptoms that come from the labral tear but you have to treat the bony issues that cause the tear as well to reliably get an excellent outcome,” said Greene.

To learn more about hip impingement at ONS, watch Dr. Greene’s full video below or click here.