Anterior Hip Replacement

Anterior hip replacement is a minimally invasive hip surgery performed to replace the hip joint without cutting through any muscles. It is also referred to as muscle sparing surgery because no muscles are cut enabling a quicker return to normal activity.

Traditionally with total hip replacement, the surgeon makes the hip incision laterally, on the side of the hip, or posteriorly, at the back of the hip. Both approaches involve cutting major muscles to access the hip joint. With the anterior approach, the incision is made in front of the hip enabling the surgeon to access the joint without cutting though any muscles.

Indications

Hip replacement is indicated in patients with arthritis of the hip joint.

Arthritis is a condition in which the articular cartilage that covers the joint surface is damaged or worn out causing pain and inflammation. Some of the causes of arthritis include:

• Advancing age
• Congenital or developmental hip diseases
• Obesity
• Previous history of hip injury or fracture
• Increased stress on hip because of overuse

Symptoms

Patients with arthritis may have a thinner articular cartilage lining, a narrowed joint space, presence of bone spurs or excessive bone growth around the edges of the hip joint. Because of all these factors arthritis patients can experience pain, stiffness, and restricted movements.

Diagnosis

Your doctor will evaluate arthritis based on the characteristic symptoms and diagnostic tests. Your orthopaedic surgeon will perform a physical examination, order X-rays and other scans, and also some blood tests to rule out any other conditions that may cause similar symptoms.

Procedure

• The procedure is performed under general anesthesia or regional anesthesia.
• You will lie down on your back, on a special operating table that enables the surgeon to perform the surgery from the front of the hip. Your surgeon may use fluoroscopic imaging during the surgery to ensure accuracy of component positioning and to minimize leg length inequality.
• Your surgeon will make an incision, about 4 inches long on the front of the hip. The muscles are pushed aside to gain access to the joint and perform the replacement.
• Next, the femur bone is separated from the acetabular socket.
• The acetabular surface is prepared using a special instrument called a reamer.
• The acetabular component is cemented or fixed with screws into the socket.
• Then a liner made up of plastic, metal, or ceramic is placed inside the acetabular component.
• The femoral head that is worn out is cut off and the femur bone is prepared using special instruments so that the new metal component fits the bone properly.
• Then the new femoral component is inserted into the femur bone either by press fit or by using special bone cement.
• The femoral head component made of ceramic or metal is then placed on the femoral stem.
• Once the artificial components are fixed in place, the instruments are withdrawn and incisions are closed with sutures and covered with a sterile dressing.