Anterior hip replacement Information

[kwmss3]

I'm tying to find information on the anterior hip replacement procedure. Specifically the difference between it and the 2 incision less invasive method normally used. There is only one doctor that performs the surgury in my town (not the Dr. I've been seeing for years, of course) and I'm a little concerned aout trying something "new". However, the 2 week recovery time sounds much better than 6-8! Any information would be much appreciated!

 

[Josephine]

Both the anterior and the minimally invasive procedures are not new, kwm. In fact, the anterior approach was devised by Smith Peterson way back in the 1920s! It has been the standard approach for THR all through the years and was used exclusively by McKee, the originator of the THR (with whom I worked in the early 60s).

The intent of the approach is that the joint can be accessed by going between the muscles and there is no need to cut or otherwise interfere with them. The only structures that are cut are the small muscles around the hip joint and the capsule itself as shown in this image.

​

Post op, the rehab is less complicated than the posterior approach. Dislocation is less of a risk, sitting is much better (you're not sitting on the incision!) and rehab is much easier. All in all, it's good, tried and tested and by far and away the best option, in my opinion.


As for the MIS (minimally invasive surgery) that has been in use for a few years now but though its benefits are good - shorter rehab and less pain - there are reported problems with getting accurate placement of the prostheses which is crucial to the long term outcome, of course. For this reason some surgeons use robotics and/or computer guided navigation. You can find a good amount of info on that here along with a couple of videos.

However, for what it's worth, I think the usage of MIS is slowly coming into the 'used enough to be ok' category. Still has some way to go, though.

Any other questions, feel free to post them!