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. Our very own Dr. Peyton is a pioneer in the approach, teaching surgeons from around the world how to perform this surgery. There are several advantages to the anterior approach, including faster recovery, decreased postoperative pain, and unrestricted movement after surgery.
First, a little history about Total Hip Replacements...
Total hip arthroplasty, known as THA, is widely considered to be one of the most successful orthopaedic interventions of its generation. The procedure provides surgeons the ability to relieve pain and restore function to patients whose joints have been destroyed by diseases such as arthritis and by trauma. In patients that require a total hip replacement, the cup-shaped hip socket and the ball of the femur are replaced with a man-made prosthetic.
While the earliest recorded attempts at hip replacements occurred in the 1890’s, these surgeries focused on replacing only one component of the hip joint. It wasn’t until the 1930’s that surgeons began experimenting with revising both the head of the femur as well as the capsule that it would sit in, in order to provide a smoother surface for movement. While this surgery has been improved with better designs and materials, the prostheses used today are nearly identical, in principle, to those designed in the early 1960’s.
While the prostheses used has undergone change, so too has the approach surgeons have used in order to place the prostheses within the joint. The traditional THA surgery involves making an incision on the side or back of the patient’s leg so that the surgeon can have access to the hip joint. In order to have optimal access to the joint in these approaches, surgeons must carefully detach important muscles that would block their access, which are later reattached. While surgeons have refined this procedure so that it’s more minimally invasive, the muscles are still damaged by this part of the procedure.
So what is so different about the anterior hip replacement?
The anterior approach to total hip replacements has emerged recently as an alternative to the more popular approaches. Although it has been in use for many years, new instrumentation that allows it to be performed with small incisions has made it more popular among surgeons.
While the traditional THA involves an incision on the side or back of your leg, the anterior approach utilizes an incision on the front of your upper thigh. Not only does this allow surgeons to use a smaller incision, but it also allows surgeons to directly approach the hip by separating, rather than cutting, the muscles that surround it. This makes it a minimally invasive, muscle-sparing operation, which gives several major advantages to the patients.
What are the advantages of an anterior hip replacement?
Limited to no hospital stay
The anterior hip replacement approach may allow the patients to leave the hospital the same day as the surgery, compared to an average stay of up to four days after the traditional approach.
Decreased postoperative pain and faster recovery
Due to the anterior approach’s muscle-sparing ability, muscular damage and bleeding caused by the surgery are minimized compared to the traditional approach. This allows patients to experience significantly less postoperative pain when compared to the traditional approach, and can lead to a faster recovery process.
Limited to no postoperative restrictions
Depending on the patient, there may also be no precautions after the anterior approach with regards to hip motions. Although each patient responds differently, this approach helps patients to bear their full weight and bend their hip freely the same day as the surgery. This can be extremely helpful for your recovery when compared to the limitations and precautions placed on patients after a traditional approach, which can restrict activities for up to eight weeks.
It's important to note that the results of total hip replacements are outstanding in terms of relief from pain and improvements to functional ability. You may still be apprehensive about receiving such an intensive surgery, and you would not be alone. Many people delay surgeries that could enhance their lives due to many factors, including fear and doubt. Surgery is, after all, a big deal. Not only will the anterior hip replacement allow you to regain lost strength and motion, but can do so even faster than the traditional approach. You don’t have to just take our word for it. Watch the video below to hear how one of our patients is doing just days after his surgery: