More than 300,000 people undergo total hip replacement each year in the U.S., mostly as a result of degenerative changes due to arthritis, but sometimes to correct other injuries or issues as well.
For years, total hip replacement surgery used two primary techniques which involved accessing the joint from the back (or posterior) or from the side (lateral). Both techniques, while effective, involve cutting major muscle groups, making recovery longer and more uncomfortable.
Anterior hip replacement surgery is a minimally-invasive technique that accesses the hip from the front, sparing the major muscles so tissue damage is minimized and recovery occurs more quickly and with much less discomfort.
How is an anterior total hip replacement performed?
Anterior hip replacement uses a specially-designed operating table that allows the hip joint to be carefully positioned so it can be accessed from the front. The procedure can be performed using general anesthesia or regional anesthesia with sedation, depending on each patient’s specific needs.
Throughout the procedure, a special imaging technique called fluoroscopy is used to ensure the joint replacement is properly positioned for the most accurate and precise fit.
The technique uses one incision about four inches long in the front of the hip so the muscles located on top of the joint can be carefully moved to one side without the need to cut through them. Next, the thigh bone, or femur, is gently separated from the cup-shaped socket portion of the joint, called the acetabulum.
The socket is cleaned of debris and the surface is smoothed to enable the socket portion of the artificial joint to fit firmly and securely. Once the socket portion is in place, a durable liner is inserted to help facilitate joint movement.
After the acetabulum portion of the joint is in place, the end of the femur is prepared. The femur portion of the artificial joint comprises a stem that is carefully inserted into the femur and a head component, which makes contact with the hip socket.
The placement of all the components is carefully evaluated before the incision is closed an covered with a sterile dressing. Before being discharged, you’ll be given complete instructions for post-op care, including information about physical therapy to help you learn to use your new joint as well as helpful guidelines to help ensure optimal joint function.
Potential benefits of anterior hip replacement compared to the traditional hip replacement surgery, may include the following:
- Smaller incision
- Minimal soft tissue trauma
- Reduced post op pain
- Less blood loss
- Shorter surgical time
- Faster healing time
- Less scarring
- Earlier mobilization
- Less post operative restrictions
- Reduced hip dislocations
- Decreased hospital stay
Normally, after a posterior total hip replacement, your surgeon would give you instructions on hip precautions to prevent dislocating the new joint. Hip precautions are very restrictive and usually include the following:
- Avoid the combined movement of bending your hip and turning in your foot.
- You should sleep with a pillow between your legs for 6 weeks.
- Avoid crossing your legs and bending your hip past a right angle.
- Avoid low chairs.
- Avoid bending over to pick things up. Grabbers are helpful as are shoe horns or slip on shoes.
- An elevated toilet seat should be used.
Recurrent Hip Replacement
Joanne needed a new hip. Doctors replaced her old joint with a titanium stem-and ball and socket, but she continued to have dislocations.
Dr. Karkare, was able to resolve the problem, and she was up and walking around in just a few short days, with no more recurrent hip dislocations, and the story made it onto the local news.
Why choose Dr. Kakare?
The anterior approach to total hip replacement surgery is a more recent advancement, and not every orthopedic surgeon has the skills and experience to perform the technique.
As a top joint replacement specialist in new York City, Dr. Karkare has extensive experience in anterior hip replacements, ensuring patients have the broadest array of safe and effective treatment options to relieve hip pain and other symptoms.
Before any procedure is performed, Dr. Karkare performs an in-depth evaluation of each patient to determine if an anterior approach could be a good choice or if another approach might be preferred, enabling every patient to make an informed, educated decision so they can feel confident in their care every step of the way.
To schedule your evaluation, call (212)951-0182 or use our online contact form to learn more.