Hip replacement - anterior approach

Experiencing hip joint pain doesn’t have to put life on hold. The pain may be caused by arthritis in the hip joint where the cartilage in the hip joint wears down to the bone. The rubbing of bone against bone causes discomfort, swelling and stiffness.

Many people suffering with hip arthritis, hip pain and stiffness choose to have a hip replacement surgery. A total hip replacement procedure removes the arthritic ball of the upper thigh bone (femur) and damaged cartilage from the hip socket. The ball is replaced with a metal ball that is fixed solidly inside the femur. The socket is replaced with a liner that is usually fixed inside a metal shell. This creates a smoothly functioning joint that doesn’t hurt. 

There are three different approaches a physician may use to gain access to the hip and perform surgery: posterior, lateral or anterior. One of the least invasive surgical options is the anterior approach – a technique that can result in less tissue damage and a faster, and more comfortable, recovery. 
 

Anterior approach for hip replacement surgery 

The anterior approach for total hip replacement surgery is a technique that minimizes the pain and time from surgery to recovery. The anterior approach allows the surgeon to reach the hip joint from the front of the hip as opposed to the lateral (side) or the posterior (back). 

By going through the front, the hip can be replaced without cutting through major muscle groups surrounding the joint as those muscles are moved aside. And without severed muscles needing to heal, recovery can happen more quickly and with less discomfort. 

Benefits of the anterior approach 

• Less pain
• Less muscle trauma. 
• Smaller incision; less scarring. 
• Faster recovery time. 
• Quicker return to normal activities. 

In addition, the anterior approach allows people to immediately bend the hip freely and bear full weight when comfortable, resulting in a more rapid return to normal functions, such as going up and down stairs before leaving the hospital. The other approaches (lateral or posterior) typically require strict precautions with limited hip motion for six to eight weeks after surgery which make normal activities like sitting in a chair or a toilet seat, putting on shoes or getting into a car that much more difficult. 

Our physicians perform the anterior approach for total hip replacement surgery at HSHS St. Vincent Hospital in Green Bay and HSHS St. Nicholas Hospital in Sheboygan.

A special surgical table aids the surgeon 

A technologically advanced HANA® Table is used for the anterior approach to improve both accessibility and visibility of the hip throughout the replacement procedure. 

The HANA® Table, available at HSHS St. Vincent Hospital in Green Bay and HSHS St. Nicholas Hospital in Sheboygan, features a normal padded upper section to support the patient’s head and torso and can be tilted as needed. The lower section is split in the middle and allows each leg of the table to move independently – rotate, lift and lower – to open the hip joint for better access during surgery. 

Once the patient is on the table, their legs are secured in place at the feet using special boots. The surgeon can then position the torso and hip in precisely the best or optimal position allowing for better visualization and improved access. All of which is not possible with a conventional surgical table. 

Benefits of the HANA® Table 

• Allows for proper placement of the incision. 
• Helps minimize the tissue damage and trauma under the skin. 
• Allows greater access to the hip joint to accurately place the implant without damaging the surrounding muscles. 
• The tables locking mechanism helps keep the hip secure without any wobbling, reducing time spent adjusting the joint’s position throughout the surgery. 
• Can generally accommodate tall, overweight and/or very muscular patients. 

On the day of surgery, you likely won’t see the table, but you can be comforted knowing your surgery is performed using advanced technology, which provides the benefit of optimal results and long-term outcomes. 

How to get started 

A total hip replacement is life-changing and the decision to have surgery shouldn’t be made lightly. There is no one-size-fits-all solution. Your physician will discuss the best surgical option to provide optimal results for your unique needs and lifestyle, including whether the anterior approach is right for you. 

Our physicians perform the anterior approach for total hip replacement surgery using the HANA® table at HSHS St. Vincent Hospital in Green Bay and HSHS St. Nicholas Hospital in Sheboygan.