Anterior Approach To A Hip Replacement

It’s a minimally invasive technique that circumvents the need to cut through muscle and tendons, drastically improving overall healing time. Dr David Slattery, a renowned hip specialist, is skilled in the precision work involved with anterior hip replacements. The anterior incision for hip replacements is around 8cm and is located in front of the hip. This technique avoids cutting muscle, and it takes a skilled hand to complete the surgery. This approach also allows for X-rays during the procedure to guide accurate implant positioning and reduce complications.

Anterior VS Posterior Hip Replacement

Posterior hip replacements are more common. Despite an extended recovery time due to surgically cutting the muscles and tendons to insert the replacement hip, this surgery is not as technically demanding as anterior hip replacement surgery.

The anterior incision for hip replacement is much smaller than for posterior surgery. By making an 8cm incision (anterior) rather than 15-20cm (posterior), the post-surgery wound is smaller. It’s also located on the front of your hip, rather than on the buttocks, which may make a difference to your comfort during the recovery phase.

Another of the advantages of anterior hip replacement is the avoidance of cutting through muscle and tendons. Skilled surgeons are able to insert your new hip without causing traumatic damage to the surrounding tissue and muscles. There is an extended recovery period associated with the posterior approach, compared with the anterior approach, because of this additional damage. Furthermore, the muscles can become weaker resulting in reduced hip stability. However, as the anterior approach hip replacement surgery avoids this problem, recovery can begin much faster.

Anterior Approach

The anterior approach to the hip joint was first described in 1881 for draining infected hips, and was first used for joint replacement in France approximately 40yrs ago.  It involves going between the muscles, rather than cutting them.  It is a technically difficult approach that was largely refined by Joel Matta in the USA and Frederic Laude in Paris with the introduction of specialised instrumentation and techniques to make it easier to place large total hip implants through a small incision (8-10cm) at the front of the hip.

Potential advantages of anterior total hip replacement:

• Smaller more cosmetic incisions
• Less muscle and tissue damage as muscles are preserved
• Quicker rehabilitation and recovery
• The ability to take X Rays during the operation to ensure leg length and precise component positioning
• Lower dislocation risk
• No post operative restrictions on range of motion

Potential disadvantages:

• Temporary numbness down the outside of the thigh due to nerve stretching
• Higher rate of fracture
• Long learning curve and specialised training required
• The need for specialised instruments and retractors
• Inability to extend the approach

Posterior Approach

The Posterior Approach was developed later and this largelysolved the problems of tendon and bone healing of the Hardinge and Lateral Approaches.  It involves an incision 15-20cm long which is curved over the buttock.  It involves splitting the Gluteus Maximus muscle and cutting the small muscles which attach to the back of the hip joint.  This is an excellent approach which can easily be extended and is the approach of choice for complex total hip replacement and revision procedures.  Potential problems associated with this approach include:

• Splitting and cutting through muscles to gain access to the hip
• Instability of the hip due to de-functioning of the muscle stabilisers of the hip
• Lateral positioning, which makes it difficult to judge leg length and component positioning
• Post operative restrictions on range of motion and longer rehabilitation

Choosing A Top Surgeon for Your Anterior Hip Replacement In Australia

Dr David Slattery is skilled and has extensive experience in both anterior and posterior surgeries, with around most of hip replacements performed through the anterior method.

When it comes to choosing the method, each patient case is reviewed on individual merits. Attention is paid to your overall health and any other specific health concerns are also considered during the decision-making process. If you have a preference, please discuss this during your consultation with Dr Slattery. It may, however, be the case that this preferred method is incompatible with other health issues. Dr Slattery will fully discuss these with you, if appropriate.

If you would like to be assessed by renowned hip specialist Dr David Slattery for a total hip replacement and are interested in the advantages of anterior hip replacement, please complete our online booking form. Alternatively, you can call one of Dr Slattery’s consulting locations to make an appointment and ask any questions that you may have READ LESS .