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What is the Anterior Approach for Total Hip Replacement?

This less invasive surgery for hip replacement allows exposure from the front of the hip joint as opposed to the side (lateral) or to the back (posterior). In the anterior approach, the hip is replaced through a natural interval between muscles. The important muscles for hip function, the gluteal muscles that attach to the posterior and lateral pelvis and femur, are left undisturbed.

Lack of disturbance of the lateral and posterior soft tissues also accounts for immediate stability of the hip and low risk of dislocation. It is normal for patients undergoing posterior incisions to follow strict precautions that limit hip motion for the first two months after surgery. Most importantly, they are instructed to limit hip flexion to no more than 60 degrees. These limitations complicate a patient’s simple daily activities such as sitting in a chair or on the toilet or just getting in a car.

Following the anterior approach, however, patients are immediately allowed to bend their hip freely and to avoid these cumbersome restrictions. Additionally, if patients are sexually active before surgery, there are no limitations on resumption of normal sexual activity after surgery.

The anterior approach for total hip replacement is less invasive, is easier on the tissues and allows the procedure to be preformed through a smaller soft tissue “window”. With this approach, muscles are not cut. Instead, they are separated naturally which results in a far quicker recovery period and far less activity restrictions than traditional hip replacement surgery.

The payoff for patients is far less pain and a much faster recovery.

Less Pain

Trauma caused by tissue damage causes pain and swelling as part of the healing process. Since anterior hip replacement requires a much smaller incision and dissection of normal tissue, the end result is less pain during recovery.

Faster Recovery

With minimally invasive anterior hip surgery, the time needed in the hospital to gain independence and to achieve comfort is considerably shortened. One clinical study found:

Traditional vs. Anterior Hip Replacement

  Traditional Anterior
Incision Size 8-10 inches 3-5 inches
Hospital Stay 5-7 days 2-3 days
Recovery Time 12 weeks 2-6 weeks

Who is a Candidate for the Anterior Approach for Total Hip Replacement?

In general, anyone can benefit from a less invasive surgical technique. In some cases, due to the size or weight of the patient, the incision must be extended, but the trauma to the surrounding tissues will still be reduced when compared to traditional surgery. Your surgeon will try to keep the incision as small as possible, but there are times when the patient is best served by a larger incision. Patients with severe deformities, heterotopic bone formation due to trauma, or previous hip replacement are not candidates for the anterior approach.

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Last Modified: January 3, 2012