|
There
has been
a
growing
new
trend in
hip
replacement
surgery
that
takes a
less
invasive
approach.
Anterior
hip
replacement
is not a
new
surgery;
however,
in the
last 5
years
the new
approach
is more
routinely
being
performed
through
smaller
incisions
with
more
specialized
instrumentation,
thereby
making
the
surgery
less
traumatic
for the
patient.
The
anterior
approach
differs
in
multiple
ways:
∙ The
hip is
exposed
in a way
where it
does not
detach
muscles
or
tendons
from the
bone. It
involves
a muscle
splitting
approach,
where
the
surgeon
gets to
the hip
between
two
muscles
(Sartorius
and
Gluteus
Medius)
rather
than
removing
and then
reattaching
the
muscle
∙ A
state-of-the-art
surgical
table is
used to
help
improve
access
to the
hip
|
Hana Table for Anterior Hip Replacement Surgery
|
∙
Intraoperative
x-ray or
computer
navigation
is
typically
used to
confirm
implant
position
and leg
length
∙ The
incision
isminimized
improving
recovery
and
improved
mobility
∙
Keeping
the
muscles
intact
may
offer a
lower
rate of
dislocation
∙ Larger
patients
may be
candidates
for
minimally
invasive
hip
surgery
with
this
technique

The
advantages
to the
Anterior
Hip
Replacement:
∙
Accelerated
recovery
time as
the
muscle
are not
detached
and
therefore
minimizes
muscle
damage
∙ The
patient
can bend
forward,
cross
legs and
bear
their
full
weight
immediately
following
surgery
resulting
in a
more
rapid
return
to
normal
activities
∙
Reduced
pain,
blood
loss,
reduced
tissue
healing
required,
and more
accurate
leg
length
control
∙
Reduced
scarring
as the
technique
allows
for one
relatively
small
incision
(4-5
inches
in the
front
compared
to 10-12
inches
on the
side and
back on
hip with
conventional
surgery)
∙
Hospital
stay is
reduced
to 2-4
days as
compared
to 3-10
days
with
conventional
method
∙ More
stability
of the
implant
sooner
since
the
muscle
and
tissues
are not
disturbed
during
the
surgical
procedure
∙
Precautions
for
anterior
hip
replacements
are to
avoid
hip
extension,
external
rotation
beyond
neutral,
no prone
lying or
bridging,
but this
is only
for 3-6
weeks as
compared
to the
opposite
precautions
for
lateral
and
posterior
hip
replacements
which
limits
hip
motion
for 6-8
weeks
post
operatively.
∙
Patients
can go
up and
down
stairs
normally
usually
before
their
hospital
release
The
disadvantages
for this
type of
surgery
is
finding
a
surgeon
to
perform
the
anterior
approach,
as it is
still
relatively
new and
specific
training
is
required.
There is
risk of
infection
and
injury
to the
surrounding
nerves.
Hip
dislocation
is
always a
risk
with
both
procedures,
but much
less
with
this
approach.
 |