anterior approach to THR

[beachlover2]

Has anyone here had the anterior (front) approach to hip replacement? They use a specially designed table where the leg is dropped in a downward fashion to get to the joint and make the incision just above the thigh in the front. If anyone has had this type surgery or knows about it, I would appreciate your input and knowledge. Thanks.

 

[Josephine]

Oh my goodness! That took me back in time - about 48 years to be exact! Ken McKee was first to devise this method for his THRs. Mind you, we didn't have such a sophisticated table as this ...

The anterior approach was, for many. many years, the one of choice as it was also used by Prof John Charnley (who, in my opinion, robbed McKee of the mantle of pioneer!! But then I am a tad biased about that!).

Looking for an image to demonstrate this I found this interesting article where it is described as 'revolutionary'! Well, it was in 1958!

There is no doubt that it gives a much better and safer access to the acetabulum and femoral shaft than the more conventional approaches, is less destructive of the muscles and therefore has a quicker recovery rate.

Hope this helps. If you have any more questions, feel free to shout!

 

[mssully]

It looks as if the anterior is the best. Why would a Dr. choose the postier approach?

 

[Josephine]

Different horses, different courses! The posterior is the approach of choice for hemiarthroplasty which is just replacing the femoral head after the old ladies fractured hip. It's an easy approach when you only need to deal with the femur. Some surgeons had used it for THRs but not many.

The other option for THRs was the antero-lateral approach (image below!) which has been the standard for many years. However, it is more invasive and takes for getting over.

posterior




antero-lateral

 

[mssully]

This surgeon uses this approach for all the surgery's he does. I guess that is the most important, the proven experiance.

 

[Josephine]

You said it, mssully - spot on!

 

[Bucha]

Has anyone here had the anterior (front) approach to hip replacement? They use a specially designed table where the leg is dropped in a downward fashion to get to the joint and make the incision just above the thigh in the front. If anyone has had this type surgery or knows about it, I would appreciate your input and knowledge. Thanks.

Yes, I had the anterior approach done on my THR last March of 2007. I had a wonderful experience with it. I had my left one done last March and will have my other hip done next year in 2009. The recovery time was so fast and speedy. I liked the fact that the incision was on the front of my leg rather than on the side and back. I do not know how people do it recovering if the incision was on the side or back. I couldn't stand it. I couldn't even lay on the side I had the replacement because it was so sore and tender.

With the anterior approach I had no rehab time at all! I was given a few exercises to do at home. I immediately started walking a football field in length getting my parents' mail each day with our dogs. I started walking about two weeks after the surgery this distance. I went back to work in six weeks.

Plus there was no restrictions of activities. I could cross my legs and I didn't have to do any adaptations at all with my activities. Plus with the anterior approach there is a very small risk of dislocation. With the Anterior Approach the risk of dislocation is pretty small compared to the conventional ways of THR in which you do have to worry about dislocation and about adaptation of daily activities to lessen the risk of dislocation. But with all of that said, I was still careful though with my daily activities. I am looking forward getting my other hip done this way next year. I am counting the days because the one side of me feels great after the THR the other side still in pain and it is stiff. I can't wait until both of my hips feel great with no pain and stiffness. I can then finally live my life without pain. I was born was very deformed hips. I was born without femar heads so I didn't start walking until after I was 2 yrs old. The femar heads finally filled in. They are shaped like cauliflower heads so I have to deal on a daily basis sever arthritis in both hips and have lived with pain all my life and limited mobility. Now that I have one of my hips done I cannot believe how I walk so much smoother now and have fluidity with my walking strive. I didn't realize this is what a normal hip should feel and perform like this. I thank God that we have surgeons who are willing to take the risk in learning these new techniques and for the medical community to keep striving to improve patients lives by coming up with new materials that withstands the test of time as well.

I am definitely doing this approach again in regards to replacing my other hip next year in 2009.

 

[Josephine]

Excellent feedback there, Bucha, and I'm truly delighted you have done so well.

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