The anterior approach to total hip replacement has recently become a practical alternative to the more popular posterior approach. This procedure, also called total hip arthroplasty, allows doctors to perform replacement surgery with a minimally invasive technique. The surgery utilizes a smaller incision on the front or anterior of the hip rather than the back or side, and it generally causes less trauma to the tissue under the skin.
Working with the smaller opening, surgeons move muscle aside with special instruments or work through available separations in muscle rather than detaching muscle from the thigh bone (femur). They then rotate the femur through the available opening and replace the damaged or arthritic femoral head with an artificial ball in the traditional fashion. Anterior hip replacement allows patients to immediately bend their hip freely and bear full weight when comfortable, resulting in a more rapid return to normal function.
Generally there is a shorter hospital stay after this surgery. With traditional hip replacement the stay is about three to five days, whereas anterior hip surgery patients normally stay only one to two days. These patients tend to experience less post-operative pain and usually enjoy a greater range of movement almost immediately. The anterior approach also leaves a smaller surgical scar and there are fewer precautions to follow to prevent dislocation, which may occur more often with the posterior approach.
There are some disadvantages to the anterior hip replacement. For medical experts, a special operating table and specific tools are required. Patients run a slightly higher risk of experiencing femoral and ankle fractures if the special table is used. In addition, due to the approach there is a substantial risk of a numb, tingling or burning sensation along the thigh. Patients who have implants or metal hardware in the hip from prior surgery as well as patients who are muscular, have a wide pelvis or are very obese may not be well suited for this procedure, and may require longer incisions.
Not all patients are candidates for the anterior hip replacement approach. Ask your doctor if this procedure is right for you.