WHAT IS 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 traditional 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. Recovery from this approach is quicker and has fewer risks of complications than the traditional approaches. With the traditional “posterior” and “lateral” approaches, the surgeon reaches the hip joint by going through the back or side of buttock and must surgically detach muscles and other soft tissue.
IS IT RIGHT FOR YOU?
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.
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, reduces greatly. 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
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 best suits his or her personal circumstances and lifestyle goals.
The video below demonstrates the procedure. Surgeries may vary based on a patient’s individual condition.