Total Hip Replacement Anterior Approach

Total Hip Replacement Anterior Approach

The anterior total hip replacement has been developed with the goal of accelerating the rehabilitation time, decreasing the risk of dislocation and minimizing the possibility of a leg length discrepancy. The anterior approach for total hip replacement is one of the minimally invasive techniques used in total hip replacement surgery. It is a tissue-sparing alternative to traditional hip replacement surgery which provides the potential for less pain, faster recovery and improved mobility, because the muscle tissues are spared during the surgical procedure. The anterior approach to the hip is the only approach to the hip that does not require splitting or dividing muscles and tendons from the femur in order to obtain access to the hip joint.

Traditional hip replacement techniques involve operating from the side (lateral) or the back (posterior) of the hip, which requires a significant disturbance of the joint and connecting tissues and an incision approximately 8-12 inches long. The anterior approach allows the surgeon to work between the muscles and tissues without detaching them from either the hip or thighbones – sparing the tissue from trauma. It involves one small incision (3 – 4 inches long) on the front (anterior) of the hip as opposed to the side or back. In this position, the surgeon does not need to detach any of the muscles or tendons. Since the incision is in the front, patients avoid the pain of sitting on the incision site. Thus, this anterior approach is associated with reduced muscle damage and pain, as well as faster post-operative recovery.

The anterior approach for total hip replacement has been gaining popularity recently. Potential benefits of this approach over the traditional hip replacement surgery may include the following:

  • Smaller incision
  • Minimal soft tissue trauma
  • Reduced post op pain
  • Shorter surgical time
  • Faster healing time
  • Less scarring
  • Earlier mobilization
  • Fewer post-operative restrictions
  • Reduced hip dislocations
  • Decreased hospital stay (average length of stay is 2.5 days)

The anterior approach differs in multiple ways from other surgery techniques:

  • The hip is exposed in a way that does not detach muscles or tendons from the bone.
  • A high-tech operating table is often used to help improve access.
  • Intraoperative x-ray or computer navigation is typically used to confirm implant position and leg length.
  • Larger, heavier patients may be candidates for minimally invasive hip surgery with this technique.
  • The anterior approach enters the body closer to the hip joint, with far less tissue between the skin and the bones of the hip, so more patients may be candidates.

Unlike hip precautions that are very restrictive with traditional hip replacement, anterior hip replacement approach has no hip precautions.