Anterior Approach Hip Replacement

For many Americans, hip replacement surgery is a revolutionary procedure that can relieve pain, restore mobility, and repair damaged joints. On average, over 450,000 hip replacement surgeries are performed annually in the United States, according to the American College of Rheumatology.  Over 1 million total hip and total knee replacement surgeries are performed each year in the U.S., according to the National Library of Medicine. One favored technique for total hip replacement surgery is the anterior approach hip replacement.

What is an anterior approach hip replacement?

There are numerous methods of performing hip joint surgery, each carrying its own set of risks and benefits. Some common approaches include a posterior (back) incision, a lateral incision, or an anterior incision. During an anterior hip replacement, the surgeon accesses the hip joint by navigating between two muscle planes and retracting the muscles aside to reach the hip joint for replacement. This technique allows your surgeon to reach the hip joint without disrupting any muscle bellies or tendons.

What are the benefits of the anterior approach?

One of the biggest benefits associated with the anterior approach hip replacement is the advantage of going in through muscle plains rather than cutting into them. Research indicates that individuals undergoing an anterior approach hip replacement experience a quicker recovery period and generally less pain. Because this particular procedure avoids the need to cut into the muscles or tendons, people tend to heal much more quickly. 

For many patients, the procedure is performed on an outpatient basis, allowing them to return home on the same day of surgery or the following morning. Since the surgery does not impact the integrity of the muscles in your hip, there is also less risk of dislocation or instability. Furthermore, this approach facilitates quicker muscle strength recovery, leading to less reliance on a walker or cane and a faster return to normal function.

Patient satisfaction with the anterior approach is overwhelmingly positive. The procedure is one of the most common surgeries performed for Medicare patients, likely due to its successful outcomes. The American Joint Replacement Registry reports an almost 98 percent satisfaction rate.

What are the risks involved with this procedure?

Before undergoing any procedure, it’s a good idea to speak to your doctor about the associated risks involved. Certain comorbidities or compounding factors may heighten or lessen the risk associated with some procedures. For individuals undergoing an anterior approach hip replacement, there is a potential of experiencing loss of sensation in the skin surrounding the incision area. During the procedure, your surgeon will make an incision in the front of the hip close to a nerve called the lateral femoral cutaneous nerve. Research indicates that approximately half of patients report permanent numbness in the skin near the incision site. The numbness shouldn’t cause any pain or discomfort, but it may feel unusual.

Following the procedure, patients shouldn’t expect a lot of restrictions. Patients should not engage in any major bending or twisting of the hip for the first six weeks post-operation. Generally, by two to six weeks patients will start to experience a reduction in pain caused by arthritis, trauma, or other degenerative conditions that led to their hip replacement. Patients may experience some soreness following the procedure, but it should subside within approximately four to six weeks, if not earlier.

How do I know if I’m a good candidate?

Not everyone is a good candidate for an anterior approach hip replacement. Those with obesity or a high BMI (body mass index) have an increased risk of skin complications and possible infection. Those who have a larger overlying stomach may run into issues during the healing process and might require different aftercare instructions to manage the skin—this may involve special dressings or more special attention during the recovery process. For that reason, your doctor may recommend a different procedure to address your hip. Additionally, those who require a more complex replacement due to bone loss or some other factor may require another procedure to access different parts of the pelvis.

“In my practice, about 98 percent of patient’s hip replacements are done through the anterior approach,” said board certified orthopedic surgeon, Kalain Workman, DO of TPMG Orthopedics in Newport News, Gloucester, and Williamsburg.

How can I learn more about this procedure?

There are risks and benefits associated with any kind of hip replacement. Although some surgeons may favor other approaches, a well-executed hip replacement should yield favorable outcomes regardless of the chosen approach. If you’re looking for more information about what approach would work well for you, talk to a TPMG orthopedic specialist today about your options.

Sabrina Brown

About Kalain Workman, DO

Kalain Workman, DO is a board certified Surgeon with TPMG Orthopedics in Newport News, Gloucester, and Williamsburg. Dr. Workman treats patients 18 years and older for a variety of joint-related conditions including osteoarthritis, rheumatoid arthritis, avascular necrosis, and fractures. He has a particular focus on osteoarthritis of the hip and knee.

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