Introduction: Traditionally, orthopaedic surgeons have used a posterior approach (through the back of the hip) for hip replacement surgery. However, recently the anterior approach (through the front of the hip) has re-­‐emerged as a viable option for some patients. Although it has been used for several decades, new technology and other advances mean it is now less invasive.

The primary advantage is that surgeons do not need to make an incision into the muscles to perform the procedure—something that must be done with posterior hip replacement. Additionally, fluoroscopy–which is like an X-­‐ray "movie”—can be used, which allows the surgeon to view the hip and its motion during the procedure.

Function: Helps restore hip alignment, mobility and function.

Diagnosis: Understanding your general health, your pain level and how your condition is affecting your everyday activities, your surgeon will perform a physical examination to analyze your hip mobility, strength and alignment. The diagnosis will also include X-­‐rays that your surgeon will use to better understand the current state of your hip and extent of the damage. Sometimes other tests may be performed, such as a magnetic resonance imaging (MRI) scan.

Treatment: Anterior hip replacement

  • Initial: Surgery is performed to remove the damaged bone and cartilage and replace it with a metal, plastic or ceramic prosthetic. The procedure generally takes a few hours.
  • Long term: Follow up monitoring with x-­‐ray or in select cases a MRI?
  • Indications for Surgery: Surgeons evaluate patients individually to determine if they are good candidates for anterior hip replacement by assessing pain and disability levels—not age, which is a common misconception. However, most patients who undergo hip replacement are adults ages 50 to 80 who have joint disease. Often it is the result of degenerative or rheumatoid arthritis, avascular necrosis, fracture on the neck of the femur or deformity of the hip.

Surgery: During anterior hip replacement, your surgeon will make a 3-­‐ to 4-­‐inch incision through the front of the leg, but not into the muscle. This makes it possible for your surgeon to access your hip joint by separating rather than cutting your muscles. The damaged bone and cartilage are then removed and replaced with the prosthesis.

Post-Operation: After surgery, you will go to a recovery room for several hours while your anesthesia is monitored, then you will be taken to your hospital room. Patients undergoing anterior hip replacement often experience a quicker recovery, shorter hospital stay and reduced muscle damage and pain than patients who have posterior hip replacement.

Rehabilitation: Most patients can stand and walk with help the day after surgery. Walking and light activity are important, however it is important to follow your doctor’s instructions in order to prevent hip dislocation. Your surgeon may discuss a variety of rehabilitation methods and options as needed, such as physical therapy, pain medications and exercises.

Risks & Complications: Risk is considered minimal, but you may experience injuries to the soft tissues, blood loss, tingling or burning sensation in your thigh. Other complications are possible, such as dislocation, inadvertent leg lengthening, infection or deep vein thrombosis.

Summary: You should seek out an experienced orthopaedic surgeon to perform your anterior hip replacement. This surgeon should be skilled at performing the surgery and knowledgeable about choosing patients who are appropriate for the procedure. While many patients are candidates for the technique, only an experienced, skilled surgeon knows for sure who will benefit most from an anterior hip replacement procedure.

To consult with a hip surgeon at Mountain Valley Orthopedics, please request an appointment online or call (570) 421-7020.

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