By Matthew A. Dobzyniak, MD
This is an important question to consider if you’re in need of a hip replacement. There are three common hip replacement procedures; anterior, posterior and lateral. In the United States, posterior and lateral are more common, however, in Europe, the anterior procedure has been popular since the 1960s. Since its US introduction in the 1990s, it has gained in popularity. While there are many advantages to an anterior hip replacement procedure, its not for everyone. Here are some factors to consider.
What Is an Anterior Hip Replacement?
An anterior hip replacement procedure approaches the surgery from the front of the hip joint as opposed to the posterior, which uses an incision from the back, or the lateral, which uses a side approach. By performing each of the procedures, surgeons were able to determine, based on the advantages and disadvantages of each one, which one would work best for different presenting hip issues.
What Are the Advantages of an Anterior Hip Replacement?
The major advantage of this procedure is that typically doctors cut little to no muscle to install the new hip, versus the amount they would cut through with a traditional procedure. It also gives surgeons greater access to the joint itself, allowing them to better match the prosthetic to the patients physical requirements. Research has also shown that it results in increased joint stability and fewer instances of dislocation throughout the life of the prosthetic. In terms of recovery, patients report less reliance on assistance devices and a faster return to normal activities. While all cases are unique, some recipients are able to return to work and driving in as little as three weeks.
What Are the Possible Disadvantages?
In some ways, an anterior hip replacement is no different from a posterior or a lateral hip replacement. They each have similar surgery times and are comparable in terms of blood loss. Additionally, the length of a hospital stay runs about the same for all three procedures. Where an anterior procedure differs most is regarding the incision. Since it is located on the front of the body, the skin at the incision point is thinner than posterior or lateral points. This can lead to an increased healing time for the incision itself. A weakened hip flexor is also a possible side effect. While these are possible drawbacks, for many patients the significant advantages outweigh them.
Who Might Be a Good Candidate for this Procedure?
Every hip replacement is different and needs to be properly evaluated by a trained surgeon. In general, those who suffer from arthritis and hip dysplasia are typically good candidates for an anterior approach. These conditions are more common in women and typically occur at an earlier age than in men. Men often need hip replacements for more structural reasons. In these cases, more invasive cuts are often required and the advantages of an anterior procedure may be lost. For this reason, your doctor may strongly suggest performing a traditional posterior or lateral hip replacement instead.
An anterior hip replacement is a good option to have available, especially if the surgeon has experience performing all three varieties.