A Q&A with Coridon Huez, M.D., Sanford Orthopedics & Sports Medicine
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: Why would someone need to get hip replacement surgery?
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 injures, 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 results in less pain, less limping, a shorter hospital stay and reduced chance of hip dislocation.
Q: How does a patient prepare for this procedure?
A: Before the surgery, the health care team reviews a full history of the patient’s health problems, including any drug allergies. The patient will also be asked about their 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 the patient’s 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 the patient is taken to the recovery room.
Q: What is the recovery process like for this type of hip replacement?
A: The patient is admitted to the hospital after surgery and is evaluated by the physical therapists 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 their legs. Most patients are discharged home the day after surgery once safely doing all necessary things to care for themselves. There are no sutures or staples to remove although patients are seen two weeks postoperatively to make sure their incision is healing well. Normal low impact activities are allowed early although higher impact activities should wait for three months once the bone heals.