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There has been a growing new trend in hip replacement surgery that takes a less invasive approach. Anterior hip replacement is not a new surgery; however, in the last 5 years the new approach is more routinely being performed through smaller incisions with more specialized instrumentation, thereby making the surgery less traumatic for the patient.
The anterior approach differs in multiple ways:
∙ The hip is exposed in a way where it does not detach muscles or tendons from the bone. It involves a muscle splitting approach, where the surgeon gets to the hip between two muscles (Sartorius and Gluteus Medius) rather than removing and then reattaching the muscle
∙ A state-of-the-art surgical table is used to help improve access to the hip
 | Hana Table for Anterior Hip Replacement Surgery
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∙ Intraoperative x-ray or computer navigation is typically used to confirm implant position and leg length
∙ The incision isminimized improving recovery and improved mobility
∙ Keeping the muscles intact may offer a lower rate of dislocation
∙ Larger patients may be candidates for minimally invasive hip surgery with this technique
The advantages to the Anterior Hip Replacement:
∙ Accelerated recovery time as the muscle are not detached and therefore minimizes muscle damage
∙ The patient can bend forward, cross legs and bear their full weight immediately following surgery resulting in a more rapid return to normal activities
∙ Reduced pain, blood loss, reduced tissue healing required, and more accurate leg length control
∙ Reduced scarring as the technique allows for one relatively small incision (4-5 inches in the front compared to 10-12 inches on the side and back on hip with conventional surgery)
∙ Hospital stay is reduced to 2-4 days as compared to 3-10 days with conventional method
∙ More stability of the implant sooner since the muscle and tissues are not disturbed during the surgical procedure
∙ Precautions for anterior hip replacements are to avoid hip extension, external rotation beyond neutral, no prone lying or bridging, but this is only for 3-6 weeks as compared to the opposite precautions for lateral and posterior hip replacements which limits hip motion for 6-8 weeks post operatively.
∙ Patients can go up and down stairs normally usually before their hospital release
The disadvantages for this type of surgery is finding a surgeon to perform the anterior approach, as it is still relatively new and specific training is required. There is risk of infection and injury to the surrounding nerves. Hip dislocation is always a risk with both procedures, but much less with this approach.
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