Anterior Approach Hip Replacement

To replace a painful hip joint with a new prosthetic joint, your surgeon either makes an incision through your buttock (posterior approach) the side of your hip, (lateral approach), or the front of your thigh (anterior approach). The approach of anterior hip replacement employed by Dr Glase means two incisions are rarely necessary.

Dr Glase will discuss the approach with you before surgery. He normally recommends the anterior approach with a single incision as long as there are no contra-indications.

Advantages of the Anterior Approach

The anterior approach hip replacement gives better overall results compared to the traditional posterior method, all else being equal.

Advantages can include:

  • Less post-op pain because the surgery uses smaller incisions compared to the posterior or lateral approach and doesn’t require cutting through major muscles.
  • Less muscle damage. By using the anterior approach, Dr Glase works between the muscles. This differs from the posterior approach which involves cutting across muscles, detaching them from the bone and then re-attaching them.
  • Faster recovery. Most of Dr Glase’s patients who have anterior total hip replacement surgery can walk with assistance within 24 hours of their surgery.
  • A shorter stay in hospital. The length of your stay will vary, but it’s likely to be shorter than if your surgeon used the posterior approach.
  • Fewer activity restrictions after surgery. After traditional posterior hip replacement surgery, your surgeon and the rehab team will probably give you restrictions on the activities you can do, especially in the short-term. For instance, you may be advised not to cross your legs, do deep knee bends or swim breaststroke. You may also need to sleep with a pillow between your legs. This is to reduce the risk of the ball of the prosthesis popping out of the socket (dislocating), which will likely require further surgery. With the anterior approach, the risk of dislocation is lower, so you’ll be able to continue to do most of your normal activities.
  • Reduced risk of limping because there is a lower incidence of muscle and nerve damage.
  • Better functional results so you can get on with your life and stop worrying about your hip.

Things to Consider

The anterior approach to total hip replacement is suitable for most patients. There is a misconception that anterior hip replacement isn’t an option if you’re very overweight or have very big muscles. Whilst this can make it more difficult for your surgeon to access the joint, it rarely precludes the anterior approach as an option.

Another common misconception is a risk of damage to the nerve that runs down the front of your pelvis. In reality, this occurs in fewer than 1% of people. In those few cases there may be a little numbness, tingling and possible irritation to the skin of your thigh but it normally resolves within weeks or months.

Most patients having undergone anterior hip replacement surgery experience a wound-healing time similar to other approaches. Occasionally it may take slightly longer but it soon resolves without extra treatment.

Make sure you select a surgeon who is trained and experienced in this procedure as anterior hip replacement is technically-demanding.  Ask lots of questions and make sure you’re comfortable with the answers.

Dr Glase has performed over 3000 anterior hip replacements and he trains other surgeons in the procedure. Less than 2% of his patients have required repeat (revision) surgery within 5 years. (National average for revision surgery within 5 years is 3.1 to 3.4%).

Summary