Anterior Hip Replacement
Anterior hip replacement is one of three common approaches (anterior, lateral and posterior) used to place a total hip replacement. It involves approaching surgery from the front of the hip joint (as opposed to the side or back of the joint).
Hip replacement surgery is one of the most successful surgical procedures of all time . It is extremely effective in alleviating pan caused by arthritis, injuries, and many other hip conditions.
The anterior approach to hip replacement, in particular, has seen a resurgence in recent years. Several surgeons at Orthopaedics SA offer the approach from hospitals across Adelaide.
Also called a minimally invasive hip replacement, this approach offers a range of benefits that can make it a great alternative to a conventional hip replacement.
If you have hip arthritis, please arrange a consultation with one of our highly qualified joint replacement surgeons to discuss how we can optimise treatment for you.
Anterior approach hip replacement allows insertion of a hip prosthesis between muscles on the front of the hip. This is a different approach to the more commonly used posterior or lateral approaches which require splitting or cutting muscles or tendons. There may be advantages with regards to operative pain and mobility in the first 6 weeks after surgery. While early recovery is important, the main focus of joint replacement is long term outcomes.
Anterior approach hip replacement uses the interval between the sartorius and tensor fascia lata muscles. The new hip is inserted with the help of gentle leg manipulation and special instruments.
Selection of the most appropriate and safest approach to surgery depends upon a number of factors, some of which relate specifically to the patient. These can include the patient’s condition, body shape and the anatomy of the patient’s hip joint.
The benefits and risks of anterior hip replacement are the same as all approaches. The main benefits are pain relief and improvement in function, walking, and quality of life. See our hip replacement information for risks of surgery.
Hip replacements performed via any approach are very successful. Some (but not all) studies report advantages from an anterior approach with regards to operative pain and mobility in the first 6 weeks.
‘Anterior’ means that the surgeon accesses the hip bone from the front of the hip, rather than the side (lateral) or back (posterior) of the hip.
Because of the way the hip’s muscles are positioned, accessing the bone from the front means the surgeon does not need to cut through any major muscles or detach them from the bone. Instead, they can work between the muscles while they replace the joint.
This means there is less muscle and soft tissue damage, which may lead to a faster recovery and improved outcomes after surgery. Some people also believe this helps stabilise the hip and decreases the risk of dislocation while in recovery.
Anterior hip replacement isn’t necessarily better or worse than a lateral or posterior hip replacement. All approaches have their benefits and fallbacks.
Current evidence shows that patients who have direct anterior hip replacements have shorter hospital stays and faster recovery in the early post-operative stages. However, there is not enough evidence to show that the anterior approach has better long-term results than lateral or posterior approaches.
You may be eligible for an anterior hip replacement if:
· Your hip pain affects your day-to-day life
· Your symptoms are not alleviated by nonsurgical treatments
· You are relatively healthy overall aside from your hip pain
However, the approach is not suitable for everyone and not all orthopaedic surgeons perform anterior hip replacement. If you believe you are suitable but have not been offered anterior hip replacement as an option, you may request a referral to an Orthopaedics SA surgeon who specialises in the area.
You also may not be eligible if you:
· Use nicotine products (including tobacco and vape products) – Nicotine increases your risk for complications during and after surgery, making an anterior hip replacement more dangerous.
· Are very muscular or overweight – anterior hip replacement is performed through a smaller incision over the front of the hip and access is not possible for all body shapes/sizes.
· Have significant medical conditions which could affect your recovery.
Studies have shown that anterior hip replacement is associated with significantly shorter hospital stays, greater functional rehabilitation, and lower levels of pain in the early recovery period .
Reported benefits of anterior approach hip replacement include:
· Smaller surgical incision and resulting scar
· Fewer precautions after surgery
· Less risk of hip dislocation
· Lower risk of different leg lengths after the surgery
· Less pain in early recovery
However, it is important to know that some studies have shown little to no difference between the anterior approach and other methods in these areas. As a result, consulting with your surgeon is important to determine the best hip replacement option for you.
Anterior hip replacement has been performed since at least 1881 . As a result, it has been heavily practiced and researched by orthopaedic surgeons in Australia and around the world. It is considered very safe and effective when performed correctly.
While anterior hip replacement has a host of benefits, it may not be the right approach for everyone.
When you book a consultation with an Orthopaedics SA surgeon, they will examine your hip, review your test results and personal medical history to determine if the anterior approach is right for you. Your surgeon will then explain all your treatment options and help you reach an informed decision about what is best for your health.
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