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Hip Replacement Surgery Has Come a Long Way: New Approach Means Less Pain and a Quicker Recovery

One of the drawbacks of traditional joint replacement surgery is the size of the surgical field necessary to access the deteriorated tissue and place the prosthetic. The amount of disturbance to soft tissue around the joint not only extends your recovery, but it also robs the joint of important support during the healing process. There is, however, an approach to hip replacement that minimizes many of the typical complications that accompany the process.

Locations of hip replacement surgery

A hip replacement procedure can be done from behind, from the side, or from the front of the hip. Advances in techniques make the front approach, called the anterior approach in medical terms, less invasive than the other options. Anterior hip replacement is also referred to as modified, minimally invasive, or mini surgery for this reason. Despite the advantages of these approaches, it’s estimated that less than 20% of hip replacements performed in the United States use the anterior approach.

Advantages of anterior hip replacement

Less disturbance of muscle tissue

Physiology favors approaching hip replacement from the front, since there are fewer muscles over the joint when compared with side and rear approaches. In addition, it’s possible to move the muscles aside, working between them, rather than cutting through or detaching muscle tissue.

Less pain after surgery

In turn, this means less pain after surgery, since there are no incisions or repairs made to major muscles. You’ll need less pain medication to manage the discomfort associated with this muscle damage.

Faster recovery

Your recovery is also faster since there’s no longer a need to wait for patched muscles to recover. You can bear weight as soon as it’s tolerable, and bending at the hip is also possible earlier in your recovery. All stages of the recovery progress faster with anterior surgery, from assisted to unassisted walking.

Less risk of dislocation

Dislocations of artificial hip joints are a concern after side and rear replacement surgery. The anterior approach leaves muscles and other soft tissue intact, and these can then support the prosthetic joint, making dislocation less likely.

Greater range of motion

Traditional hip replacements require patients to avoid sitting with their legs crossed for at least two months after surgery, as well as avoiding deep hip bending and extreme hip rotation longer term. Anterior replacement offers a greater range of movement in terms of bending and sitting with crossed legs. Here, too, the risk of dislocation is reduced.

Disadvantages of anterior hip replacement

Perhaps the biggest disadvantage of the anterior approach is that some patients may not be good candidates, particularly those with lots of muscle mass or the obese, since the additional tissue complicates an already challenging surgical process. Since less soft tissue is disturbed using this approach, visualizing the joint is more difficult.

While nerve damage is a risk associated with any hip replacement surgery, the anterior approach increases risk to the lateral cutaneous femoral nerve running down the front of the pelvis, while potentially reducing the risk to the sciatic nerve, which runs behind the hip joint.

The demands of anterior hip replacement require a surgeon with dedicated training and experience. Contact Wellington Orthopaedics and Sports Medicine to learn more about the anterior hip replacement procedure.

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