Hip

Total Hip Replacement, Anterior Approach

What it is
The Anterior Approach for total hip replacement is a tissue-sparing alternative to traditional hip replacement surgery that provides the potential for less pain, faster recovery and improved mobility because the muscle tissues are spared during the surgical procedure. The technique allows the surgeon to work between your muscles and tissues without detaching them from either the hip or thighbones - sparing the tissue from trauma.

Keeping the muscles intact may also help to prevent dislocations. With the Anterior Approach, the surgeon uses one small incision on the front (anterior) of your hip as opposed to the side or back. Since the incision is in front, you’ll avoid the pain of sitting on the incision site.

The Anterior Approach Incision
The Anterior Approach procedure for total hip replacement has been gaining popularity recently due to its potential benefits:

• Possible accelerated recovery time because key muscles are not detached during the operation. (Some other procedures require cutting or disturbing the important muscles at the side or back of the leg.) The Anterior Approach is known as a tissue-sparing procedure because it avoids cutting these key muscles and tissues and therefore minimizes muscle damage
• Potential for fewer restrictions during recovery. Although each patient responds differently, this procedure seeks to help patients more freely bend their hip and bear their full weight immediately or soon after surgery
• Possible reduced scarring because the technique allows for one relatively small incision
• Potential for stability of the implant sooner after the surgery, resulting in part from the fact that the key muscles and tissues are not disturbed during the operation. 

The Anterior Approach differs in multiple ways from other surgery techniques:

• The hip is exposed in a way that does not detach muscles or tendons from the bone.
• A high-tech operating table is often used to help improve access.
• Intraoperative x-ray or computer navigation is typically used to confirm implant position and leg length
• Larger, heavier patients—may be candidates for minimally invasive hip surgery with this technique
• The Anterior Approach enters the body closer to the hip joint, with far less tissue between the skin and the bones of the hip, so more patients may be candidates

Every surgical approach has risks and benefits. The performance of a hip replacement depends on your age, weight, activity level and other factors. There are potential risks, and recovery takes time. People with conditions limiting rehabilitation should not have this surgery. Only an orthopaedic surgeon can tell if hip replacement is right for you.

References:
1. Comparison THA procedure data on file at DePuy Orthopaedics, Inc.
2. Matta, J.M. and T.A. Ferguson. “THA After Acetabular Fracture.” Orthopedics September 2005, 28(9): 959-960.
3. Matta, J.M., C. Shahrdar and T.A. Ferguson. “Single-Incision Anterior Approach for Total Hip Arthroplasty on an Orthopaedic Table.” Clinical Orthopaedics and Related Research December 2005. 441: 115-124.


To read the entire article from the American Academy of Orthopaedic Surgeons, click here.

Source from AAOS, Viewmedica, WebMD