Direct Anterior Hip Replacement

Total hip replacement procedures have an extremely high success rate. However, often patients will complain about complications such as prosthetic dislocation, postoperative weakness of the hip muscle group and a diminished range of motion. For these reasons, the orthopedic community has worked hard over the years to develop advancements to the traditional total hip replacement approach.

While traditional hip replacements may be successfully performed with no complications, in order to achieve the maximum benefits of the advancements of modern medicine, patients will likely be recommended the Anterior Hip Replacement approach.

How Is Direct Anterior Hip Replacement Surgery Different?

Total hip replacement surgery involves the removal of the hip joint and replacing it, thereafter, with an artificial metal-alloy joint. The traditional hip replacement method requires the surgeon to make a rather large incision on the side of the hip or back. This not only creates a larger incision site but forces the surgical team to cut through critical soft tissue near the hip in order to comfortably perform the operation.

The method known as Direct Anterior Hip Replacement allows the surgeon to make the incision directly in front of the hip and perform the replacement from this position, which allows the surgeon to operate between muscles and tendons.

This method allows the surgeon to make a significantly smaller incision while minimizing trauma to the muscles of the leg and hip. Access to the hip joint is managed by moving the muscles and tendons aside. So while it is more difficult to perform, it is also much more efficient.

By minimizing tissue damage, patients not only experience less immediate pain and discomfort, but are also allowed to maintain more of their original strength and stability to better protect and support the replacement hip.

What Should I Expect Before, During, And After A Direct Anterior Hip Replacement?

Arriving to the mutual consensus of a Direct Anterior Hip Replacement surgery involves an initial consultation that will include discussing the patient’s symptoms, medical history and performing any necessary medical testing to understand the extent of the patient’s condition. The patient will then work closely with their physician to discuss their treatment options. If the patient is experience severe hip pain and extremely limited motion, total hip replacement will be the best medical treatment for the patient’s symptoms. The surgeon will go over the steps of the procedure and the likely results so that the patient is extremely comfortable and confident heading into the procedure.

The night before the procedure, patients will be asked not to eat or drink immediately before bed, as general anesthesia will be required. When the patient arrives, they will be positioned onto the operating table and given the anesthesia. The surgical team will then make the small incisions through the front of the hip and perform the operation. An arthroscope will be utilized to provide doctors a clear view of the surgical area, allowing for the incision sites to be as minimal as possible. The damaged hip ball and/or socket will be removed, as well as any other damaged tissue and replaced with a metal, plastic or ceramic implant.

The average Direct Anterior Hip Replacement surgery lasts anywhere between 80 to 160 minutes, and most patients are able to walk the day after the operation with the aid of a cane or walker. The Direct Anterior Hip Replacement approach leads to a faster recovery and patients can expect these benefits:

• Significantly less postoperative pain is reported by patients
• The surgeon is able to keep soft-tissue (muscles and tendons) trauma to a minimum
• Smaller incisions
• The patient spends less time under the effects of anesthesia
• Faster post-operative recovery compared to traditional hip replacement surgery
• Due to the lack of soft-tissue damage near the newly replaced hip, the postoperative hip is immediately stronger and less likely to become displaced
• Quicker recovery leads to earlier mobility