Total Hip Replacement Anterior Approach

Benefits of the Anterior total hip replacement approach

hip replacementSurgeons consider the Anterior Approach for total hip replacement as a tissue-sparing alternative to traditional hip replacement surgery to treat endstage osteoarthritis.  Providing the potential for less pain, a faster recovery and improved mobility due to sparing muscle tissues during the surgical procedure opposed to other approaches that cut through the muscle before reattaching it before closing. This 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 on the front of the leg the patient avoids the pain of sitting on the incision site.

The Anterior Approach Incision possible benefits

couple walkingThe Anterior Approach procedure for total hip replacement has gained 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.

Anterior Approach Vs. Other Approaches

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

  • The surgeon exposes the hip in a way that does not detach muscles or tendons from the bone.
  • A high-tech operating table helps improve access.
  • Use of intraoperative x-ray or computer navigation confirms implant position and leg length.
  • The technique allows for a higher upper limit on body mass due to the minimally invasive nature of the approach.
  • 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 orthopedic surgeon can tell if hip replacement is right for you. Over time the replacement will wear out and hip revision surgery, with or without bone allograft reconstruction, will replace any worn out parts in patients fortunate enough to outlive their implants.

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.

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