Anterior Hip Replacement

Anterior hip replacement can be a great option for patients considering total hip replacement. Anterior total hip replacement offers several benefits over the more traditional approaches.

Dr. Kenneth Sands is a board certified orthopaedic surgeon with over 20 years of experience. He has been almost exclusively using the anterior approach for total hip replacement for over a decade because he believes the outcomes are beneficial to patients. More recently, he has switched to a direct anterior approach with a “bikini” incision that is more cosmetically appealing.

Additionally, Dr. Sands has been involved with the design and development of different tools and implants used for anterior hip replacement. He helped to develop a special bed attachment that is an alternative to the Hana table and gives surgeons more hands-on, direct control of the patient’s extremities during surgery. He is also on the design team for a femoral hip stem implant designed by and for anterior total hip replacements.

When to Consider Anterior Hip Replacement

The decision to proceed with hip replacement is a personal choice. Dr. Sands advises patients to consider the different factors at play, including but not limited to age, health, work, social obligations and personal beliefs. Essentially, quality of life should guide your decision.

The following symptoms may indicate that hip replacement surgery would be beneficial:

• Chronic hip pain that limits your daily activities, including walking and bending
• Hip pain that persists even while resting (potentially affecting sleep at night)
• Significant stiffness in the hip that limits your range of motion
• Pain and loss of function that continues even with conservative treatments

Benefits of Anterior Hip Replacement

Dr. Sands’s goal with anterior hip replacement is to restore function and reduce or eliminate hip pain.

Anterior hip replacement offers several benefits over traditional hip replacement techniques, including:

• Decreased risk of dislocation after surgery
• Less pain during the initial recovery period
• Faster recovery time
• Easier recovery

Anterior Hip Replacement Procedure

Dr. Sands uses the anterior approach for nearly all of the hip replacements that he performs. In rare cases, including hardware from a previous surgery or anatomic differences, the anterior approach may not be the best option.

On average, an anterior hip replacement takes about an hour to complete. During the procedure, Dr. Sands makes the incision at the natural interval between the sartorius muscle and the tensor fascia lata. This allows him to complete the procedure without cutting any muscles. This differs from the traditional posterior approach for hip replacement, which requires muscles to be cut to access the joint.

Because the anterior approach avoids cutting and reattaching muscles, the recovery tends to be easier and less painful.

The hip replacement implant is made of titanium, while the head/ball of the implant is typically ceramic.

Recovering from Anterior Hip Replacement

Dr. Sands does the vast majority of anterior hip replacements as an outpatient procedure, so patients are able to return home the same day. In cases where patients do need to stay at the hospital, most are able to go home after one night.

Following anterior hip replacement, most patients immediately feel much better than they did before surgery. Pain levels vary from patient to patient. For most, the pain is the worst during the first week of recovery, and the pain decreases significantly within the first 10-14 days. Typically, pain is not constant and is easily managed with medication. Patients are encouraged to wean off of narcotic medication as soon as they are comfortable. Often, patients are comfortable taking extra strength Tylenol during the day and only taking narcotic medication at night.

Mobility & Physical Therapy

Patients will use a walker to get around for a day to a week, then use a cane for an additional few weeks. Most people are able to stop using the walker and cane within 3-6 weeks. Many people have even been able to start walking unassisted within the first week or two.

Patients typically do outpatient physical therapy for 6 weeks after surgery. In cases where patients are unable to get to outpatient therapy, our team will arrange for home health care.

Return to Activity & Full Recovery

The time it takes to safely return to normal activity will vary from patient to patient. It often depends on the patient’s conditioning before surgery and which activities they wish to resume. Some can resume their daily activities within the first week; for others, it may take a month. Dr. Sands will advise when returning to activity is safe for each patient based on their individual needs.

With an anterior total hip replacement, there is about an 0.2% risk of dislocation. Because of this, Dr. Sands restricts bending the hip past 90 degrees with twisting for 4 weeks after surgery out of an abundance of caution, until the muscles become stronger. Patients typically do not have permanent restrictions, but are generally advised to avoid running long distances.

For patients who wish to be more active, sports like golf can typically be resumed within 3 months of surgery. More extreme activities may take 6-12 months to safely resume.

Anterior Hip Replacement in Melbourne, FL

Dr. Kenneth Sands is a board certified orthopaedic surgeon with over 20 years of experience. He is fellowship trained and specializes in joint replacement surgery. Dr. Sands utilizes the anterior approach for the vast majority of his patients because it provides several benefits over the traditional posterior approach. In many cases, anterior hip replacement can be done as an outpatient procedure, allowing patients to return home the same day.

If you would like to learn more or schedule an appointment with Dr. Sands, please call our office at (407) 643-1234.