How is anterior hip replacement surgery performed?
Anterior hip replacement is a relatively new surgical method that, unlike the posterior or posterior lateral approach, the patient lies on their back and not on their side. Access to the hip is made through a four-inch incision to the outside area of and just below the groin. After the incision is made, the surgeon locates two muscles, which are pushed to the side in order to allow access to the area. The hip is then replaced, including the ball and socket and other components. Unlike other surgical procedures, no muscles are detached or split. Thus, before closing the incision no repair has to be done to any muscles. Upon completion of the replacement the incision is closed.
How is anterior hip replacement different from traditional hip replacement surgery?
Generally speaking, it is a less involved procedure. There is no cutting or splitting of muscles, access to the area is easier, and fewer muscles are involved. Traditional surgery includes making an incision from the buttocks that curves around to the outside of the hip. Then the buttock muscles are split and four other muscles are detached. All of these muscles must be repaired after the hip is replaced. With anterior hip replacement surgery, no muscles are split or detached, and only two are pushed to the side during surgery.
What are the benefits of anterior hip replacement surgery?
Any successful hip replacement surgery will improve a patient’s quality of life by allowing them to be more mobile, physically active, and involved in activities associated with work and leisure. However, there are benefits that are related specifically to the anterior hip replacement method.
Because muscles from the back of the hip are not cut, there is minimal muscle trauma, which allows for faster healing and reduced pain. Plus, due to the fact that muscles are not detached, there is less risk after surgery of the patient suffering a hip dislocation.
Post-surgery discomfort is also reduced due to the location of the incision, which is below and in the outer region of the groin area for the anterior method. Traditional technique involves the buttock muscles, which, weeks after the surgery is complete, affects sitting and sleeping. Finally, there is more comfort in terms of equal leg length, as the anterior method makes it easier for the surgeon to obtain optimum balance between the legs.
What precautions must be taken after anterior hip replacement surgery and are they different than those taken after traditional hip replacement surgery?
Prior to and following posterior hip replacement surgery, there are numerous precautions that surgeons must discuss with their patients. They must be taken after surgery is performed, and are numerous. These precautions do not apply to those who undergo the anterior hip replacement procedure.
The reason for taking the following safety measures is to guard against dislocating the new hip, which is a common complication. Precautions include:
- For the first four to six weeks after surgery, a pillow must be placed between the legs when sitting or lying down.
- For the first four weeks, patients who are recovering must sleep on their back with a pillow between their legs
- Hips or knees must not be bent beyond 90 degrees during this time.
- Leg crossing, inward turning of toes, and tying of shoes are also prohibited.
- Low chairs or couches should not be sat on.
- To preserve to 90-degree rule, patients are encouraged to use an elevated toilet.
With anterior hip replacement, the risk of dislocation is virtually eliminated. Thus, as noted, there is no need to follow the precautions outlined above.
In what ways is rehabilitation different for anterior hip replacement surgery than it is for posterior?
First of all, due to the fact that the above addressed precautions have been eliminated, rehabilitation for anterior hip replacement is much different than that for the posterior process. Muscle trauma is greatly reduced with the anterior method, which makes for a rehabilitation timeline that is much faster.
A patient having undergone anterior hip replacement surgery finds it’s much easier to use a walker, and, two to three weeks after the operation, they can progress to using a cane. Within four to five weeks, a patient is usually walking without the aid of a cane, and they can resume normal activity very shortly after that.
With posterior hip replacement surgery a patient utilizes a walker for the initial four to six weeks and then a cane for three to four more weeks. They will often be walking independently after approximately 10 weeks. A patient may resume their normal activities in about 12 weeks.
How invasive is anterior hip replacement surgery?
Although anterior hip replacement surgery is less invasive than the posterior method, it is still considered to be a major operation and invasive surgery. This is due to the fact that anterior hip replacement surgery involves a patient being put under an anesthetic, and their being exposed to blood loss and the cutting of bone. Plus, the joint area is opened up. All of these factors involve a certain amount of risk.
Do all orthopedic surgeons perform anterior hip replacement surgery?
No, not all orthopedic surgeons use this technique. Most surgeons have been trained in posterior hip replacement, which is a very effective method. It is still the most common technique used. In order to perform anterior hip replacement surgery, a doctor will have to be exposed to other surgeons knowledgeable about and experienced in the procedure. This costs money and takes time. Plus, a hospital would have to invest in special equipment, including an operating table designed for the procedure.
Is anterior hip replacement surgery more expensive and does my insurance cover it?
Anterior hip replacement surgery is more expensive, however, it does not cost a patient any more money to have this type of surgery performed. All insurances cover both types of procedures.
OSPI is the top orthopedic practice in the East Valley. Chandler and Gilbert orthopedic surgeons at the practice offer anterior hip replacement surgery along with cutting edge procedures such as stem cell therapy procedures. Most insurance is accepted, call 480-899-4333 for more information and scheduling with top orthopedic surgeons Gilbert, Chandler and Mesa trusts.