An anterior hip replacement is a surgical procedure in which damaged bones in your hip joint are replaced with an artificial hip (total hip arthroplasty). Other names for the procedure are minimally invasive or muscle sparing hip arthroplasty.
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Traditionally, surgeons perform hip replacement surgery by making an incision behind (posterior approach) or on the side (lateral approach) of your hip. Since about 1980, it’s become more common for surgeons to make the incision in the front of your hip. This is called an anterior approach or anterior hip replacement.
An anterior approach has become more popular because it’s less invasive than posterior and lateral approaches. Entering your hip from the front causes less damage to surrounding muscles and tendons, which leads to a faster recovery.
Also, it can almost always be done as an outpatient procedure, so you can go home on the same day you have surgery.
The goal of hip replacement surgery is to improve function and range of motion and relieve pain in a damaged hip.
common reasons hip joints fail
The most common causes of damaged hip joints that might lead to a hip replacement are:
- osteoarthritis (age-related wear and tear)
- rheumatoid arthritis
- infection (osteomyelitis)
- a tumor
- loss of blood supply (avascular necrosis)
- abnormal growth (dysplasia)
The anterior approach is most often used when arthritis is the reason for a hip replacement. But it also be used to replace hips with any type of damage. It can even be used to fix a hip that has previously been replaced.
However, doctors may decide to use a different surgical approach in unusual cases where the position of the hip bones makes it too difficult, or other health conditions increase the risk of complications.
As with any procedure, you should prepare for it ahead of time and know what to expect during and after surgery while you recover.
It’s important that your doctor has the most accurate and current information about you and your health before surgery to help ensure the best outcome.
what your doctor will ask
Things your doctor will want to know about you before surgery include:
- previous surgeries and anesthesia you’ve had
- allergies to medication, food, and other things like latex gloves
- all medications and supplements you take, both prescription and over the counter
- current and past medical problems
- symptoms of a recent infection or other problem
- problems any close relatives have had with anesthesia
- if you are or might be pregnant (for women of childbearing age)
You will likely get instructions before surgery, such as:
- Avoid eating or drinking 8 to 12 hours before surgery.
- Avoid certain medications, if any.
- Have someone drive you home and stay with you after outpatient surgery.
You’ll receive anesthesia at the beginning of the procedure. This stops you from feeling any pain during the operation.
If you have an outpatient procedure, you’ll most likely have regional anesthesia. The medication that numbs your lower body will be injected into the space around your spinal cord. You’ll also receive sedation to make you sleepy.
The other option is general anesthesia, which will make you unconscious so you don’t feel anything during the surgery.
what happens during surgery
After the anesthesia begins to work, the surgeon:
- cleans and sterilizes the area around the front of your hip
- covers the area with sterile drapes
- makes an incision in front of your hip joint
- moves the muscle and other tissue out of the way until the bones in your joint are visible
- removes the upper part of your thigh bone (the “ball” of your hip joint) and any damaged bone and cartilage in your pelvic bone (the “socket” of your hip bone)
- attaches an artificial ball to your thigh bone and socket to your pelvic bone
- makes sure everything is placed right so your legs are equal length
- closes the incision
You’ll then be moved to the recovery room, where the anesthesia will wear off in an hour or two.
Once you are stable, someone can take you home if you’re having outpatient surgery. Otherwise you’ll be moved to your hospital room.
You should be able to put weight on your new hip soon after surgery and may be able to walk using a walker or crutches the next day.
You’ll need physical therapy to regain strength and mobility, and occupational therapy to work on daily activities like getting dressed and washing up. Some people have outpatient physical therapy, others receive physical therapy at home, and others go to a nursing home or rehabilitation facility.
It typically takes four to six weeks before you’ve got the strength and range of motion to get around and perform daily activities like before surgery.
Most people can return to work after about a month, but it may take up to three months before you can return to work that requires a lot of standing, walking, or heavy lifting.
The benefits of hip replacement in general are increased mobility and decreased pain.
Unlike in lateral and posterior approaches, muscles and tendons don’t have to be cut when an anterior approach is used for hip replacement. This has many benefits.
anterior hip replacement BENEFITS
- less pain
- faster and easier recovery
- earlier hospital discharge
- more functionality when discharged to go home
- usually can be done as an outpatient
- fewer restrictions on activity after surgery
- lower risk of hip dislocation after surgery
- lower risk of different leg lengths after surgery
The risks of anterior hip replacement are the same as other hip replacement approaches.
anterior hip replacement risks
- complications of general anesthesia, such as postoperative delirium and postoperative cognitive dysfunction
- heavy bleeding during surgery or from your incision
- blood clot in your leg (deep vein thrombosis) that can move to your lung (pulmonary embolism)
- hip joint infection (septic arthritis)
- hip bone infection (osteomyelitis)
- injury to nearby muscles and nerves
- dislocation of your hip joint
- different leg lengths
- loose joint
In the short-term, anterior hip replacement is less painful and leads to a quicker recovery of mobility and strength compared to a posterior or lateral approach. The long-term outcome is very good and similar to other approaches.
Occasionally, an artificial hip becomes loose or wears out after several years and has to be replaced. However, anterior hip replacement is a safe and effective procedure. Most likely your new hip will function well and improve your quality of life for many years.