Submitted by: Tom Murdoch

Anterior hip replacement is fast becoming the preferred approach to hip surgery, out favoring the traditional approach and offering faster recovery with less pain. If you have been told you need a hip replacement, or have been suffering from chronic hip pain, you may be the perfect candidate for this procedure.

What is the difference between approaches?

In the traditional approach, a large 7to 8 inch incision is made in the back (posterior) or the side (lateral) of the hip. With either of these approaches, the gluteus (buttock) muscles must be cut. Much of the pain following hip replacement surgery is due to detachment, repair and healing of these cut muscles. With the anterior approach, a smaller 3 incision in the front of the hip is made. There is no need to disturb the muscles- instead, surgeons work through the natural opening between the muscles. As a result, recovery is faster and there is far less pain than with the traditional approach.

Who is a good candidate for the anterior approach?

Almost anyone who is a candidate for hip replacement surgery is a good candidate for anterior hip repair. Typical candidates are generally people over the age of 50 who have chronic hip pain resulting from osteoarthritis or rheumatoid arthritis, where the cartilage between the head of the femur (the ball) and the acetabulum (the concave surface of the pelvis, or socket) has worn away, causing bone on bone pain when walking or performing other weight-bearing activities.

With the advancement of prosthetic materials, artificial joint life has been greatly extended, making the surgery more attractive to persons in their 40s.

Patients who are obese, who have had a previous hip replacement on the hip in question or who have severe hip dysplasia or overgrowth of the hip bone (heterotopic bone formation) may not be good candidates for the anterior approach.

What are the advantages of the anterior approach?

There are many advantages of the anterior approach, including:

smaller incision

less pain and scarring

lower risk of hip dislocation following surgery as the muscles supporting the hip are not disrupted

more exacting placement of the installed components, resulting in a longer lasting prosthesis

decreased leg length discrepancy

fewer hip precautions following surgery- patients are able to resume activities, including walking and flexing the hip, almost immediately

Shorter hospital stay and a faster recovery- patients are often home the next day and recovery is approximately 2 to 8 weeks, as opposed to 2 to 4 months for the traditional approach

What makes the anterior approach possible? The anterior approach is possible due in large part to the use of a specially designed table that allows for specific positioning during surgery. The Hana table is designed to allow rotation and hyperextension of the leg and hip, which permits the surgeon to more accurately and precisely, fit the prosthetic device. The table is made of a carbon fiber, which allows the surgeon to view scan images of the operative site during the surgery, permitting greater leg length accuracy. The combination of the specialized table and the imaging system make the anterior approach possible.

How do I find a surgeon who uses the anterior approach? Not all surgeons are trained at the anterior approach to hip replacement. The need for specialized equipment and training means there are fewer surgeons who offer anterior approach to hip replacement surgery.

The Holland Bone and Joint Center in Holland, Michigan offers this less invasive and specialized technology, and treats patients from around the world who wish to undergo this hip replacement option, allowing them to return to their normal activities sooner and with less pain. The Center provides quality care, expertise and personalized service to patients from all walks of life, including Olympic athletes. The Hana table and a specialized imaging system are routinely used at the Center for anterior hip repairs.

If you are wondering whether you are a candidate for anterior hip replacement, physicians at the Holland Bone and Joint Center will gladly review any imaging studies you have had done elsewhere and will work with your family physician to coordinate the care you need and deserve.

About the Author: Tom Murdoch is West Michigan area s expert, specialist in general orthopedics, hip replacement and sports medicine. Contact his center yourself by calling 616.738.4420.

hollandboneandjoint.com

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