What is Anterior Hip Replacement?

The development of less invasive procedures for hip replacement surgery is good news for people whose hip joints have been damaged by arthritis or other joint conditions. Anterior hip replacement, a minimally invasive surgery for people with hip joint disease, is one such procedure. For many, anterior hip replacement is associated with a faster and less painful recovery than traditional hip replacement. As a result, the technique is gaining in popularity.

In traditional hip replacement surgery, surgeons access the joint area through the upper thigh, either through the lateral part, or side, or the posterior part, or back. The incision, which usually begins at or near the buttocks and then follows the line of the hip down the leg, can be as long as 12 inches (30.48 cm). During the surgery, the patient lies on the opposite side, and the surgeon must detach several major muscles from the pelvis or femur, the thighbone, in order to reach the hip joint. The detached muscles must then be reattached after the new joint is in place.

In contrast, anterior hip replacement is performed with the patient lying on his or her back on a specially designed surgical table. This position lets the surgeon access the joint from the front of the hip area without surgically detaching any muscles. Instead, the hip joint is reached through naturally occurring openings between the muscles. With the patient on his or her back, the surgeon is able to accurately measure and compare leg length on both sides. In addition, for eligible patients with joint disease in both hips, anterior hip replacement can be used to replace both hips in a single operation.

Post-operatively, a key advantage to anterior hip replacement is the elimination of the strict movement restrictions that follow traditional hip replacement. With traditional surgery, patients are not allowed to flex the hip joint more than 90° to reduce the risk of dislocation of the replaced joint. These restrictions, which are usually in place for six to eight weeks after surgery, mean that it can take two to four months before a person is able to return to full activity. With anterior hip replacement, the return to normal activity is typically faster because patients are allowed to move the hip freely right after surgery.

While the risk of dislocation is lower with anterior hip replacement, complications may develop following any type of hip replacement surgery. These include infection, nerve damage, and circulatory problems. In addition, surgery to revise or correct the original procedure is sometimes needed.

In general, anterior hip replacement represents a promising addition to the arsenal of techniques available to orthopedic surgeons and their patients. With less trauma to body tissues during surgery and faster recovery times, this type of hip replacement offers advantages to many people with hip joint disease. As more surgeons become skilled in the procedure, more patients may benefit from its availability.