Hip replacement surgery is one of the most common and successful orthopedic procedures performed in the United States. There are multiple ways for surgeons to perform hip replacements, with the classic and most common technique through the posterior approach, where the surgeon makes the incision on the back or side of the leg. A newer technique shown to have many benefits is an anterior approach. Eric Buxbaum, DO, an orthopedic surgeon at CentraState, shares his thoughts on this procedure.
What is direct anterior hip replacement surgery?
This minimally invasive procedure is performed through an incision made on the front of the leg. It’s considered a “muscle-sparing” approach, as we use a natural opening between the muscles around the hip to reach the hip joint.
What are the benefits of this approach?
Because the incision is only 3 or 4 inches long compared to up to 12 inches with the classic posterior approach, there is less damage to nearby tissue. Rather than cutting into muscles and tendons to reach the damaged hip, we carefully move the muscles aside while inserting the implant, and then move them back into place. This helps reduce pain, speed recovery, and provide greater stability to the hip compared to the posterior approach. Patients benefit from a shorter hospital stay—sometimes even returning home the same day—and a quicker return to normal activities.
What should you expect during and after surgery?
A hip replacement surgery usually takes several hours. It requires general or regional anesthesia; your doctor can help decide which option is best for you. Patients begin walking immediately after surgery and gradually increase mobility. While a complete recovery can take between three and six months, many patients return to normal daily activities sooner.
Who is a candidate for hip replacement surgery?
People with hip pain and disability that disrupt their regular activities may be candidates for hip replacement, especially if first-line treatments such as physical therapy and medication don’t provide relief. Total hip replacements have been performed successfully on people of all ages, but most patients are between ages 50 to 80. The anterior approach with a surgeon well-versed in this technique is an option for many patients, although the decision between an anterior and posterior approach can depend in some cases on factors like pelvic structure, anatomy, body mass index (BMI), and issues like diabetes and kidney disease.
When making the decision to have hip replacement surgery and which approach is best, it’s important to have a conversation with your surgeon about the benefits and risks specific to you. The good news is that the techniques and instruments used for hip replacement keep improving, which means more positive outcomes and better quality of life for patients.