ANTERIOR APPROACH HIP REPLACEMENT

Minimally-invasive hip replacement

A total hip replacement is a type of joint replacement surgery. Replacing your hip joint with an artificial one will decrease pain while increasing mobility. In the medical field, it is called total hip arthroplasty. An orthopedic surgeon can do these procedures from behind the hip, to the side of the hip, or from in front of the hip. Total hip replacement with an anterior approach refers to surgeries done from in the front of the hip. These surgeries may also be called mini, modified, minimally invasive, or muscle-sparing surgeries.  Dr. Greiner of Greiner Orthopedics is one of only a few orthopedics in Kansas City that does anterior approach hip replacements.

Anterior Approach Hip Replacement involves a 3–4 inch incision on the front of the hip, allowing the joint to be replaced by moving muscles aside along their natural tissue planes, while not detaching any tendons. Benefits of this approach typically include speedier recovery, less pain, and more normal hip function after hip replacement. Since the tendons aren’t detached from the hip during the direct anterior hip replacement procedure, normal hip precautions are generally are not necessary. Benefits of this procedure include patients returning to normal daily activities in a short period of time after surgery with minimal risk of

Minimally Invasive Hip Replacement, A Direct Anterior Approach

We understand that making sure you know what to expect from the hip replacement experience is important to you. If you have additional questions as you are reading through this material, please reach out to us to discuss.

Diagnosis and Treatment of Hip Pain

A diagram of the hip joint and its location.

Each patient is unique and can experience hip pain for different reasons. It’s important to talk to us about the cause of your hip pain so you can understand the treatment options available to you. One common cause of hip pain is arthritis, a degenerative condition that involves the breakdown of cartilage and bones in the hip joint. Pain from arthritis and joint degeneration can be constant, come and go, occur with movement or after a period of rest, or be located in one spot or many parts of the body. If you haven’t experienced adequate relief with medication and other conservative treatments, hip replacement may provide you with relief from your arthritis.

Total Hip Replacement

Total hip replacement involves removing arthritic bone and damaged cartilage in the hip joint and replacing them with an implant. The hip joint is generally described as a ball-and-socket joint. Take a look at how the end of the thigh-bone (femoral head) is replaced with a metal stem and an artificial ball that is secured to the top of the stem. The hip socket (acetabulum) is reconstructed, typically using a metal cup lined with durable plastic (polyethylene). The femoral and acetabular components work together to form the artificial hip implant.

Direct anterior approach

Your surgery may be performed using the Direct Anterior Approach, a minimally invasive surgical technique used in total hip replacement. This technique may be associated with:

  • reduced muscle damage 1
  • reduced pain 1
  • faster post-operative recovery 1

What are the differences between the Direct Anterior Approach and a traditional hip replacement? One difference is the location of the incision. During a traditional hip replacement, the surgeon will operate on the patient from the side. Using the Direct In Anterior Approach, the surgeon operates on the patient from the front.2 Another difference is the length of the incision. Traditional hip replacement may require an 10–12 inch incision 3 while the incision used in the Direct Anterior Approach may be 3–4 inches in length.2

Important information

Hip Replacements

Hip joint replacement is intended for use in individuals with joint disease resulting from degenerative and rheumatoid arthritis, avascular necrosis, fracture of the neck of the femur, or functional deformity of the hip.

Joint replacement surgery is not appropriate for patients with certain types of infections or any mental or neuromuscular disorder that would create an unacceptable risk of prosthesis instability, prosthesis fixation failure, complications in postoperative care, compromised bone stock, skeletal immaturity, severe instability of the joint, or excessive body weight.

Like any surgery, joint replacement surgery has serious risks, which include, but are not limited to, pain, bone fracture, change in the treated leg length (hip), joint stiffness, hip joint fusion, amputation, peripheral neuropathies (nerve damage), circulatory compromise (including deep vein thrombosis (blood clots in the legs)), genitourinary disorders (including kidney failure), gastrointestinal disorders (including paralytic ileus (loss of intestinal digestive movement)), vascular disorders (including thrombus (blood clots), blood loss, or changes in blood pressure or heart rhythm), bronchopulmonary disorders (including emboli, stroke or pneumonia), heart attack, and death.

Implant related risks which may lead to a revision of the implant include dislocation, loosening, fracture, nerve damage, heterotopic bone formation (abnormal bone growth in tissue), wear of the implant, metal sensitivity, soft tissue imbalance, osteolysis (localized progressive bone loss), audible sounds during motion, and reaction to particle debris.

The information presented is for educational purposes only. Speak to your doctor to decide if joint replacement surgery is appropriate for you. Individual results vary and not all patients will return to the same activity level. The lifetime of any joint replacement is limited and depends on several factors like patient weight and activity level. Your doctor will counsel you about strategies to potentially prolong the lifetime of the device, including avoiding high-impact activities, such as running, as well as maintaining a healthy weight. It is important to closely follow your physician’s instructions regarding post-surgery activity, treatment and follow-up care. Ask your doctor if a joint replacement is right for you.

Stryker Corporation or its other divisions or other corporate affiliated entities own, use, or have applied for the following trademarks or service marks: Stryker. All other trademarks are trademarks of their respected owners or holders.

References

  1. Post, Zachary D., MD; Orozco, Fabio, MD; Diaz-Ledezma, Claudio, MD; Hozack, William J., MD; Ong, Alvin, MD 2014 © Journal of the American Academy of Orthopedic Surgeons.
  2. Wenz, J., Gurkan, I. Jibodh, S., “Mini-Incision Total Hip Arthroplasty: A Comparative Assessment of Perioperative Outcomes,” Orthopedics Magazine, 2002.
  3. AAOS website, http://orthoinfo.aaos.org/topic.cfm?topic=a00404, accessed March 2016.