Anterior hip replacement is a minimally invasive type of total hip replacement surgery. The procedure removes the diseased and painful area of the hip and replaces it with a man-made, ball-and-socket to restore the hip’s natural function.
The main difference between the anterior approach and traditional total hip replacement is the location of the surgical incision. The doctor performs this version of hip arthroplasty (hip replacement surgery) at the front of the hip. Traditional hip replacement surgery is performed on the lateral (side) or posterior (back) of the hip.
Anterior hip replacement is used in 15 to 20 percent of hip replacement procedures, today. During an anterior hip replacement, the surgeon accesses the hip joint through a small incision. The surgeon guides the instruments between the leg muscles to remove the failing femoral head and cup-shaped socket. He or she then replaces the diseased sections with metal, ceramic or plastic components. Instead of cutting the muscles attached to the pelvis, thigh and gluteus, the anterior approach allows the supporting muscles to remain intact.
What are the benefits of anterior hip replacement?
Anterior hip replacement causes less trauma to the patient’s body. As a result, the anterior approach:
- Reduces pain. There is less pain during recovery. Patients often need less medication.
- Shortens hospital stays for patients who do not encounter complications after surgery.
- Speeds recovery. Six days doesn’t sound like a long time unless you’re trying to navigate stairs while using crutches or a walker. A small study of 54 patients found that people who opted for anterior hip replacement were independently mobile 6 days earlier than patients who underwent a traditional hip replacement surgery. The overall improvement in recovery time for the anterior approach compared to conventional hip replacement surgery is estimated to be 2 to 4 weeks faster.
- Allows nearly normal movement, almost immediately. Traditional hip replacement surgery usually requires movement limitations for the first 6 to 8 weeks after surgery. This restriction allows the supporting leg muscles to heal and strengthen. The intact muscular structure begins providing support for the new joint immediately.
- Reduces the risk of post-surgical hip dislocations. Since the muscles are not detached, these soft tissues support the replacement and prevent the ball and socket from dislocating.
What are the risks of anterior approach hip replacement?
Although anterior hip replacement is considered a minimally invasive surgery, it is still surgery. All surgery comes with risks from anesthesia, infection and other complications, such as:
- Bleeding, blood clots and other wound healing issues
- Nerve injuries in the femoral nerve that can leave the thigh numb
- Hip joint dislocation
- Changes in leg length
- A loosening of the hip joint
The goal of all hip replacement procedures is to reduce pain and restore movement. Unfortunately, a few people develop new pain or may have less mobility after surgery, but this is a rare occurrence. Before you have any surgery, talk to your healthcare provider about the risks and benefits of the procedure.
Who benefits from total hip replacement with the anterior approach?
People who experience pain and inflammation in the hip or those who need to use a walking aid may benefit from hip replacement surgery. Hip replacements also may help people who suffer from:
- Osteoarthritis – a condition caused by long-term wear and tear
- Rheumatoid arthritis – an autoimmune, inflammatory condition that damages joint tissues and causes pain, swelling and stiffness
- A traumatic hip injury
- Osteonecrosis or avascular necrosis – Conditions resulting in the death of the bone due to restricted blood flow
- Tumors in the leg, pelvis or hip
If you have recurring or chronic hip pain, make an appointment with your healthcare provider or an orthopedic specialist to discuss your options.
Anterior hip replacement may not be appropriate for everyone.
Anterior hip replacement is a procedure that should be performed by an experienced surgeon. Accessing the hip joint through the front of the leg, between the muscles can be challenging. Before you agree to anterior hip replacement surgery, make sure your surgeon has the training and expertise to perform your surgery successfully.
Anterior hip replacement requires a healthy foundation for a successful result. Qualified and conscientious surgeons screen candidates for the anterior approach. He or she will assess your general health, age, lifestyle, habits and bone health to ensure your hip is healthy enough for the procedure. People who are obese or those who have a strong muscular structure in their hips and legs may not be the best candidates for anterior hip replacement surgery. The additional soft tissues and the strength of the muscles make the hip joint harder to access and the surgery more difficult to complete. People who have hip dysplasia (malformation) or necrosis of the hip, may not be good candidates either.
If you are not a candidate for the anterior approach, there are other surgical options, such as traditional total joint replacement or hip resurfacing that may provide you with relief. Talk with your healthcare provider to see which option would work best for your condition.
What happens after a total hip replacement with the anterior approach?
After surgery, your orthopedic team will get you up and have you walking as soon as possible. You will need to use a cane or crutches at first until your balance returns and your strength and mobility increases.
When you are discharged from the hospital, your surgeon will refer you to a physical therapist for exercises and therapy to help you regain as much mobility, strength and flexibility in your hip as possible. With an anterior hip replacement, there are fewer movement restrictions involving bending and flexing after surgery.