Total hip replacement is a very common and effective procedure for relieving pain and allowing for better function.
Traditionally, hip replacements have been done through a posterior approach, meaning the hip is opened from the back. This requires an incision through the big muscle of the rear end (the gluteus/’butt’ muscles), as well as detachment of some of the stabilizing muscles of the hip (the external rotators).
An older method for performing hip replacement was through a lateral or anterolateral approach. In this case the front of the hip joint was exposed, requiring the surgeon to cut through the hip abductors of the gluteus medius. This generally will end up resulting in a limp.
However, in the past few years great success has been found with an anterior approach. Instead of cutting through the muscles, we go in between the muscles at the front of the thigh to expose the hip. This allows for much less muscle weakness, faster recovery and less risk of the hip dislocating as it heals! Another benefit that has been found is that there is a reduced risk of blood clots.
I have been performing anterior hip replacements for over two and a half years and am a strong proponent of this technique. One of my main reasons for moving to a this method is that I have seen a significantly faster recovery in my patients. In many cases my patients who had their hip replacement done with an anterior approach are walking with a cane or without any walking aid at all within two weeks of their surgery!
Patients who have a hip replaced with an anterior approach have a much greater ability to climb stairs and an easier time getting up from a seated position. This is because using the anterior approach we do not have to cut through the stabilizing muscles that help with these functions. This also means there is no need for post-operative restrictions, including limits on range of motion. Finally, our positioning of the implants is improved due to our ability to use x-ray guidance. We can better recreate the normal anatomy and give you a better functioning hip.