Q: What is a total hip replacement with anterior approach?
A: Also known as hip arthroplasty, a total hip replacement is a type of surgery that replaces a patient’s hip joint with an artificial one. A surgeon can perform this procedure through multiple approaches. With an anterior approach the surgery is done from the front of the hip.
Q: How do I know when hip pain becomes too much and I may need a hip replacement?
A: The purpose of most hip replacements is to treat pain and damage from arthritis, but a replacement procedure can also be used to manage other hip injuries, hip fracture or replace bone that has broken down from reduced blood flow. Hip replacement surgery eases pain and helps movement in each of these situations.
Most patients pursue surgery not because the pain suddenly becomes severe but because of the limitations it imposes on their life and the activities they enjoy.
Q: What are the benefits of an anterior approach?
A: Total hip replacement with an anterior approach can provide a faster initial recovery for patients. Using the anterior approach allows a surgeon to do the procedure through a smaller incision in the front of the hip, gaining access to the hip joint by cutting fewer muscles and tendons. Less cutting reduces the amount of overall muscle trauma that results from the surgery.
An anterior approach can result in less pain, less limping, a shorter hospital stay, and reduced chance of hip dislocation.
Q: How do I prepare for this procedure?
A: Before the surgery, the health care team reviews a full history of your health problems, including any drug allergies. You will also be asked about your current medications or supplements, pregnancy and any recent health issues, such as fevers.
In some cases, a physician may want to run some tests before the procedure to get more information about the hip and surrounding tissues. These tests will include X-rays or sometimes MRI scans.
Q: What happens during a total hip replacement with anterior approach?
A: An orthopedic surgeon and specially trained assistants perform the surgery, which may take one to two hours. The surgeon begins by making an incision in front of your hip joint and separating the muscles to gain access to the joint. The upper part of the femur is removed, along with the damaged cartilage and bone from the pelvis.
The surgeon either press-fits or uses bone cement to replace the worn surfaces with the metal implants. Finally, an X-ray is taken to verify the positioning of the implants. Then the incision is closed and you are taken to the recovery room.
Q: What is the recovery process like for this type of hip replacement?
A: You can expect a short stay or same-day surgery and to be evaluated by physical therapists on the day of surgery. Weight bearing is allowed immediately although a walker or crutches may be needed initially while recovering. There are no postoperative range of motion restrictions or special precautions needed such as raised toilet seats or sleeping with a pillow between your legs.
Most patients are discharged home the same day or the day after surgery once safely doing all necessary things to care for themselves. There are no sutures or staples to remove although you will be seen two weeks after surgery to make sure your incision is healing well.
Normal low-impact activities are allowed early although higher impact activities should wait for three months once the bone heals.
Q: How painful is recovery from hip replacement surgery?
A: All patients will have some level of pain or discomfort after surgery. Our goal is to help manage your pain. You will have access to medications that have been ordered by your physician. Other methods we use for pain control are ice, repositioning, activity, aromatherapy, music or anything you have found helpful at home.
You will be asked to rate your pain on a scale of 0-10 (with 10 being worst). We will also ask that you share a comfort goal that you feel is tolerable. Most patients find a pain goal of 4-5 acceptable after surgery. Your physician will determine which type of pain medication is best for you. Please notify your nurse if your pain is not controlled by the medications we are using.
Q: When can I return to normal activity?
A: You will begin moving the day of surgery with assistance from nursing staff and a walker or crutches. Then, depending on your post-op progress, you should be able to graduate from a walker to a cane in one to two weeks and to independent walking within two to four weeks. Your surgeon or therapist will help guide this change based on your individual progress.
You can resume low-impact activities such as walking, swimming, and golfing after you heal. Consult with your surgeon or therapist if you have questions about specific sports.
You can travel when you feel comfortable. Remember to stretch and walk at least once an hour and do ankle pumps while sitting to avoid blood clots.
Most patients can drive by two to four weeks after surgery, but it will depend on which limb is affected and how well you are functioning. You should not drive while taking pain medication. Consult with your surgeon or therapist about timing.
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