An Anterior Hip Replacement is commonly needed to relieve the pain and restore movement in a hip with arthritis. In the surgery the hip bone and socket are replaced by a man-made implant and without complications will last 20-30 years.
This surgery has routinely been performed for the last 50 years with great success. So why do you need to consider an Anterior Total Hip Replacement?
It is all about the preserving the muscles
Muscles of the hip; The gluteal muscles are vital for hip strength and with the posterior approach they are cut open to access the hip joint.
What is an Anterior Hip Replacement?
An Anterior Hip Replacement is when the surgeon makes a short anterior skin incision to access the hip joint. The muscles are only parted to access the hip joint. With the more traditional Posterior Hip Replacement the gluteal muscles are cut open to access the hip joint.
Anterior Approach The front muscles are parted to access the hip joint – like the curtains being opened
Posterior Approach The back muscles are cut to access the hip joint – like the window being smashed
So why is the Anterior Approach Hip Replacement becoming more prominent?
Less Damage to Major Muscles The anterior muscles are parted, not cut, therefore the hip strength is preserved and less rehabilitation after the operation is needed
Less Post-Operative Pain As the muscles are intact, the only pain is from the surgery itself, which is well controlled by pain medication. People have the operation in the morning and get up and walk in the afternoon.
Faster Recovery With no muscle damage and good pain control, there are many stories about walking out of hospital 2 days after the operation and back at work within 2 weeks.
Shorter Hospital Stay Minimal pain + No muscle damage + Earlier movement = Home earlier
Decreased Risk of Hip Dislocation Posterior approach dislocation positions are hip bending > 90° and legs crossed. Particularly in the first 3 months patients have to be pedantic about avoiding dislocating positions and for the rest of their life be wary. Anterior Approach has a significantly reduced chance of dislocating as the position is toes out in full extension – an extremely unlikely occurrence.
While we are on the topic of dislocation, the subject about what positions during sexual intimacy are a good or bad idea is very important but usually avoided. Anterior Approach recipients do not need to worry about positions in case of dislocation, Posterior Approach most certainly do.
So why aren’t all Hip Replacements an Anterior approach?
It is not suitable for Obese Patients as their abdominal mass may make it hard for the surgeon to access the front of the hip, their high abdominal fat content may compromise wound healing and any skin infections in deep creases may track into the incision and infect the implant.
Also the operation is Technically Demanding. For some surgeons who have mastered the art perfectly of a Posterior Approach, they may not be prepared to start the learning curve all over again. It is similar to the idea of riding a bike forwards, then having to learn how to ride it all over again but this time backwards. Your chosen surgeon should be performing a high volume of these operations (>1 x week) to be sufficiently skilled.
Before you have major surgery, exhaust all conservative options (physiotherapy and exercise), do your research on your surgeon and get another opinion to confirm everything. It is your body, you have to be in charge of your own health.