- Sports Medicine
- What’s New?
The Anterior Approach to hip replacement surgery allows the surgeon to reach the hip joint from the front of the hip as opposed to the lateral (side) or the posterior (back) approach. This way, the hip can be replaced without detachment of muscle from the pelvis or femur during surgery. The surgeon can simply work through the natural interval between the muscles. The most important muscles for hip function, the gluteal muscles that attach to the pelvis and femur, are left undisturbed and, therefore, do not require a healing process to recover from surgical trauma.
Conventional lateral or posterior surgery typically requires strict precautions for the patient. Most patients must limit hip motion for 6 to 8 weeks after surgery. They must limit flexing of the hip to no more than 60 to 90 degrees which complicates normal activities like sitting in a chair, on a toilet seat, putting on shoes or getting into a car. Simply climbing stairs may also be more difficult during recovery.
Anterior Hip Replacement allows patients to immediately bend their hip freely and bear full weight when comfortable, resulting in a more rapid return to normal function. After surgery, patients are instructed to use their hip normally without cumbersome restrictions. In supervised therapy, patients go up and down stairs before their hospital release.
The anterior approach hip replacement is a muscle-splitting approach, meaning that the surgeon gets to the hip between two muscles, rather than by removing and then reattaching a muscle. The advantage is thought to be that rehabilitation can proceed more quickly by not having to allow the reattached muscle to heal.
The “abductor pillow” that is used between your legs for traditional or posterior approaches for 6 weeks is not required with the anterior approach. This allows for more natural movements of the hip which may improve your sleep and exercise.
Radiography is routinely used throughout the procedure. Traditional surgery usual obtains X-ray in the recovery room after the operation. Positioning of the implants have been completed and any errors accepted. By using real time X-ray guidance, this assures more precise positioning of components. Perfect component positioning improves the outcome of leg lengths, stability and longevity of the implant. Hence, there is less dislocation risk and more natural hip biomechanics are reproduced by reproducing the center of rotation, offset, and muscle resting length. My patients have enjoyed a more speedy recovery with less pain and commonly discard their walker the first week after surgery. I enjoy knowing that the implants are properly placed every time before the end of surgery.