Anterior hip replacement
What is anterior hip replacement?
An anterior hip replacement (also called total hip replacement or total hip arthroplasty with an anterior approach) is a type of surgery in which your hip joint is replaced with an artificial ball and socket. With anterior hip replacement, the surgeon approaches the hip from the front of the body during surgery. It is a less invasive procedure compared to the traditional method of hip replacement, in which your surgeon would approach your hip surgically from the back (posterior) of your body, through the buttock.
Why anterior hip replacement is done
The most common causes of hip pain are degenerative joint disease and osteoarthritis. You may develop these conditions as a result of aging, playing sports or injuries. If you have damage to your hip joint and hip pain that interferes with your daily activities, you may be a candidate for hip replacement surgery. A hip replacement can relieve your pain and help you move and function better.
An anterior hip replacement offers many advantages over a posterior hip replacement, including more rapid recovery and less pain after surgery. With anterior hip replacement, most patients can regain their strength quickly following surgery and are able to return home soon (usually the same day as surgery or the next day). There is also less damage to the surrounding muscles and tissue and fewer restrictions on a patient’s movements after the hip is replaced.
Complications of total hip replacement
Problems with hip replacement surgery are rare; however, any surgery can lead to potential complications. Those associated with hip replacement include damage to the nerves around the hip or breaking the bones near the implant. Having an experienced, skilled surgeon performing your hip replacement surgery reduces your risk of these types of issues.
Your surgeon will also talk to you about other ways to reduce the risks associated with your hip replacement. You may be prescribed medications such as blood thinners or aspirin to reduce your chances of getting a blood clot or antibiotics to reduce your risk of developing an infection.
What to expect in surgery
During a hip replacement, your surgeon replaces the worn ball-and-socket joint in your hip with a new, artificial joint. The artificial joint is made out of a combination of metal (titanium), plastic and ceramic parts. Your surgeon will choose the correct implant size for you and will fit the implant to your body, and your own bone will eventually grow into the implant, securing it into position. The artificial joint is immediately stable after being surgically placed into your body. During the anterior approach hip replacement surgery, your doctor will stretch the muscles around the hip bone but will not need to cut them.
With anterior hip replacement, your surgeon will have better access to the part of your hip where surgery is required. He or she may also be able to make a smaller incision with this method. You can expect the same results and longevity as you would with other approaches to hip replacement.
For anterior hip replacement surgery, most patients receive spinal anesthesia, which numbs the body from the belly button through the toes. This lasts from 2-3 hours after surgery and then you regain full function of your muscles and sensation. Your anesthesiologist may also give you another type of medication to sedate you, ensuring you are relaxed and pain-free.
Anterior hip replacement surgery only takes about one and a half hours to complete. The young, healthy patient may be able to go home the same day, but the majority of patients spend 1-2 nights in the hospital after surgery.
How to prepare
Follow any instructions your doctor gives you prior to your anterior hip replacement and take any medications as prescribed. Be prepared to spend most of the day at the hospital the day of your surgery, or to spend several nights in the hospital following surgery.
The recovery process
After your spinal anesthesia wears off, your healthcare team will have you get up and start walking around with a physical therapist. You can expect some muscle soreness (as your surgeon will have to stretch your muscles during surgery). You may need to use a cane, crutches, or walker for the first 1-2 weeks after surgery.
You should expect to start doing physical therapy the same day as your surgery, and to continue to do physical therapy for several weeks following your surgery. You will either be doing this at home or in a physical therapy (PT) office as an outpatient. At Northwell Health, we also provide our patients with a virtual physical therapy alternative, accessible via the internet or on a smartphone, which some patients choose to use to augment their physical therapy as well.
You should have very few limitations on your movement after you have anterior hip replacement. Your doctor will let you know when it is okay to return to activities like driving, working, running and playing sports. Most patients find they can return to driving within two to three weeks and can return to work in two to six weeks, depending on their job function.
Today’s total hip replacements are very effective and are long-lasting. Although it is possible it may need to be replaced due to wear, you can expect your artificial joint to last 25 years or longer.