Hip Replacement – Performing the Anterior Approach
Considering a hip replacement is no easy decision. There are various procedures in the orthopedic marketplace. There are 3 common approaches to the hip replacement. The Posterior Approach is the most common traditional approach. The lateral approach has a lower dislocation risk but a much higher incidence of limp after surgery. I have been performing the anterior approach for total hip replacement for years. In fact, I am the only orthopedic surgeon in Kirkland, WA that performs this procedure.
How does the anterior approach to total hip replacement differ from the traditional hip replacement surgery? For one, the anterior approach is a tissue-sparing alternative. The approach to the hip from the front does not involve cutting any major structures to get to the hip. Instead, the interval between two muscles is separated, leading to the hip capsule. I work between your muscles and tissues without detaching them from either the pelvis or thighbones – sparing the tissue from trauma. The Traditional posterior approach from the back requires dividing the gluteus maximus (butt) muscle and splitting part of the ilio-tibial band on the side of the hip and then cutting several small tendons off the back of the hip.
Many surgeons are hesitant to perform the anterior approach because it is new since their training. The special equipment necessary to perform this approach has only been popularizer in the past 5 years. This approach is through a much smaller incision and is technically demanding. The anterior approach uses a special table called a Hana table that allows me to position the leg in a very specific way to place the hip components. All of the operating room staff and my assistants are used to doing this approach.
Benefits to the anterior approach for hip replacement include:
- Faster recovery time and improved mobility – The muscle tissues are spared during the surgical procedure
- Less pain – No hip precautions when at home like having to put a pillow between the legs when at rest
- Limping is eliminated on average 16 days after anterior hip approach vs. 24 days after a posterior approach. Pain relief is faster, 98% of patients are off narcotics 2 weeks after an anterior approach, vs. 70% off narcotics after a posterior approach.
- Agility – There are no restrictions on hip flexion after an anterior approach.
If you are considering hip replacement and would like more information, please call me at 425-823-400 or email me at ProOrthoAppointment@proliancesurgeons.com to schedule an appointment.