If you’ve been experiencing hip pain and told you need a hip replacement due to arthritis, traumatic injury, or congenital defect, you may be considering the anterior (front) approach for hip replacement instead of the posterior (back) approach. While it’s not a new procedure, the anterior approach has experienced a resurgence in recent years.
According to Bradley Reddick, D.O., an orthopedic surgeon on staff at Bone and Joint Hospital at St. Anthony, the anterior approach has been around for years but has changed slightly from earlier techniques. In addition to specialized instruments, redesigned surgical tables are now available to help manipulate exposure to the leg hip joint during surgery. This makes the procedure safer and easier for the patient. The surgeon also uses a live X-ray (C-arm) during surgery which they can’t utilize during the posterior approach. This allows them to see cup and stem placement in real time. It also allows them to judge leg length and how far to off-set the implant.
“Basically, the anterior approach differs in the approach or the surgical entry point,” says Dr. Reddick. “The joint implant size is the same regardless of the approach; however the surgical incision is smaller with the anterior approach.” He goes on to say 90 percent of his patients are candidates for this approach but there are some anatomic confines that will dictate which approach is used.
“For the patient, there are two distinct advantages to this approach – early rehabilitation and lower dislocation rate,” says Dr. Reddick. “With the anterior approach there’s typically a 10 centimeter incision and with the posterior the incision could range from 15 to 30 centimeters. Because you’re approaching the joint from the front, you’re avoiding the muscles and tendons that are impacted during the posterior approach and that can lead to a shorter hospital stay and faster recovery and rehabilitation process.”
According to Dr. Reddick, with the anterior approach you can expect to stay in the hospital two to three days. You will be standing the day following surgery with the assistance of your physical therapist, if not sooner. The surgical dressing is changed and the IV is removed on the second post-op day. “Some patients will actually go home that night,” he says. After going home, people will use a walker for two to three weeks and are considered “recovered” after six weeks. “During the six week recovery period patients have certain restrictions such as no twisting, impact or bicycling. After the six weeks there are no restrictions,” explains Dr. Reddick
“For the posterior approach the patient typically spends three days in the hospital,” says Dr. Reddick. “They’ll be on a walker for six weeks and placed on hip precautions for three months. These precautions include not crossing his or her legs, not flexing the hip past 90 degrees, not turning the hip in or out, and sleeping on their back with a pillow between their knees. Additionally, they’re discouraged from picking up anything off the floor and must use an elevated toilet seat.”
As with any surgical procedure, you should discuss your options with your surgeon who will recommend the best procedure for you.
For a contact information on Dr. Reddick or our other orthopedic surgeons, please call the physician referral line at 405.272.7900.
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