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Anterior approach hip replacement

January 19, 2018

Anterior approach hip replacement provides four distinct benefits to the hip replacement patient.

The anterior approach is one in which the orthopedic surgeon approaches the hip joint from the front of the hip, as opposed to the side (lateral) or back (posterior). The incision is a small one, just 3 – 4,” making anterior approach hip replacement a minimally invasive procedure. The muscles are not cut, they are merely pushed aside to give the surgeon access to the hip joint. This results in less pain for the patient.

As you would expect, a smaller incision and less trauma to the muscles involved means a faster recovery for the patient undergoing anterior approach hip replacement. They are up walking, bearing full weight on their operative hip, the same day as surgery. Most patients need only the assistance of a cane to walk about during the first week of recovery. They can return to normal activities such as golf, tennis, and biking in as few as four weeks.

Anterior approach hip replacement patients enjoy freedom of movement following their surgery. They are instructed to use their hip as they normally would, whereas patients undergoing conventional hip replacement must restrict flexing of the hip to no more than 60 – 90 degrees. That complicates normal activities like sitting, bending, and climbing stairs.

During anterior approach hip replacement surgery, the surgeon uses a specialized X-ray machine called a fluoroscope. The fluoroscope allows the surgeon to see the placing of the hip implant in real time. He or she can make adjustments immediately, giving the patient the most accurate placement possible. The surgeon can ensure the patient’s leg lengths are equal before leaving the operating room, avoiding gait problems.

Although anterior approach hip replacement has been popular in Europe since the 1940s, it is a technical demanding and time-consuming procedure when performed using conventional operating tables. Because of this, fewer than 40% of the nation’s orthopedic surgeons seek out the extra training required to offer this procedure to their patients.

In 2005, a specialized operating table was introduced, designed exclusively for anterior approach hip replacement. The Hana® table maneuvers patients’ legs into various positions required during surgery. Dr. Zehr uses this table and the anterior approach hip replacement technique on virtually all of his primary hip replacement patients. Since 2010, he has performed over 2,300 anterior approach hip replacements.