There are many approaches to hip arthroplasty and there are benefits and drawbacks to each. From a patient perspective, what will make a difference in the long-term is a capable surgeon who is able to execute the procedure with minimal tissue damage, in a reasonable amount of operative time, and will place the components in the correct position with care to restore the anatomy of the hip. This does not mean the smallest incision or any particular approach. I will use posterior and anterior approaches depending on what is right for the patient. The vast majority of my patients are treated with an anterior approach hip replacement.
There are many approaches to hip arthroplasty and there are benefits and drawbacks to each. From a patient perspective, what will make a difference in the long-term is a capable surgeon who is able to execute the procedure with minimal tissue damage, in a reasonable amount of operative time, and will place the components in the correct position with care to restore the anatomy of the hip. This does not mean the smallest incision or any particular approach. I will use posterior and anterior approaches depending on what is right for the patient. The vast majority of my patients are treated with an anterior approach hip replacement.
Dislocation is a major complication of hip arthroplasty, and results when the head of the prosthetic hip is forced out of the acetabular cup component. This requires procedures and possibly revision surgery to correct. Anterior approach hip replacement may have the benefit of a lower dislocation rate. In my practice I do not require activity restrictions or precautions post-operatively. The posterior tissues of the hip are preserved, and it is these tissues that provide stability and prevent the most common posterior dislocations. Dislocation is still possible, but very rare.
Dislocation is a major complication of hip arthroplasty, and results when the head of the prosthetic hip is forced out of the acetabular cup component. This requires procedures and possibly revision surgery to correct. Anterior approach hip replacement may have the benefit of a lower dislocation rate. In my practice I do not require activity restrictions or precautions post-operatively. The posterior tissues of the hip are preserved, and it is these tissues that provide stability and prevent the most common posterior dislocations. Dislocation is still possible, but very rare.
There is also some information that recovery may be more rapid after anterior hip replacement. I believe this may be true, but the literature is variable and may not be comparing apples to apples. Again, having an experienced surgeon is going to be more important.
There is also some information that recovery may be more rapid after anterior hip replacement. I believe this may be true, but the literature is variable and may not be comparing apples to apples. Again, having an experienced surgeon is going to be more important.
The anterior approach allows the patient to be in the supine position (laying on back) for the surgery, which allows easy use of a specialized orthopedic table (Hana Table), X-ray flouroscopy, and computer navigation technologies, all of which which I rely on. This helps ensure consistent, accurate restoration of the anatomy of the hip and correct component position. These measures are important to minimizing wear of the implant and complications like dislocation. You can follow the link to the VELYS/JOINTPOINT site to explore one of the navigation suites I commonly utilize.
The anterior approach allows the patient to be in the supine position (laying on back) for the surgery, which allows easy use of a specialized orthopedic table (Hana Table), X-ray flouroscopy, and computer navigation technologies, all of which which I rely on. This helps ensure consistent, accurate restoration of the anatomy of the hip and correct component position. These measures are important to minimizing wear of the implant and complications like dislocation. You can follow the link to the VELYS/JOINTPOINT site to explore one of the navigation suites I commonly utilize.
The downside of the anterior approach is that it can be challenging to master the technique. It has a learning curve for new surgeons that may result in complications. The approach does place more stress on the femur for exposure, and in very soft bone, fractures of the tip of the hip and rarely the shaft can occur. This is obviously a major issue when it happens, and thankfully it is uncommon.
The downside of the anterior approach is that it can be challenging to master the technique. It has a learning curve for new surgeons that may result in complications. The approach does place more stress on the femur for exposure, and in very soft bone, fractures of the tip of the hip and rarely the shaft can occur. This is obviously a major issue when it happens, and thankfully it is uncommon.
Another drawback includes some numbness around the incision. This tends to be temporary and goes away by 3 months in most people. It is also uncommon.
Another drawback includes some numbness around the incision. This tends to be temporary and goes away by 3 months in most people. It is also uncommon.
Hip flexion weakness may be present early as the hip flexors run in the anterior aspect of the hip and are in the area of the approach. This is also temporary.
Hip flexion weakness may be present early as the hip flexors run in the anterior aspect of the hip and are in the area of the approach. This is also temporary.
Please click on the video below to get an idea of the surgical approach.
Please click on the video below to get an idea of the surgical approach.
Anterior hip approach surgical animation video
Anterior hip approach surgical animation video
AA_Animation_Dec2014 (1).mp4Page updated
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