Deerfield, Posted by happybug @happybug , Apr 2, 2019 What factors come into play on a doctor’s decision to do anterior vs posterior hip replacement? Low risk of dislocation when performed by a specialty-trained surgeon with a high volume of hip replacement. Cartilage is a tissue that helps joints move. At 8 weeks, direct anterior patients had higher mean Harris hip scores (95 versus 89) but a lower return to work and driving with no difference in their use of gait aids, … A metal socket is placed in the pelvis, similar to the hip replacement procedure. Anterior hip replacement may provide some benefits in terms of speeding the early recovery timeline, although even this is a subjective debate. Posterior hip replacement surgery uses a curved incision on the side and back of the hip. Whether these specialized tools and tables are necessary for better outcomes is a matter of ongoing research. For patients with osteoarthritis or that have experienced trauma to their hip, a total hip replacement can restore function and decrease pain. In addition, be prepared to ask your surgeon about their experience, complications, and overall outcomes. Researchers found that patients who underwent direct anterior approach (DAA) total hip arthroplasty had objectively faster recovery than patients who had mini-posterior approach. September 29, 2020.  |  Hip replacement surgery is a common procedure that is performed to alleviate hip pain and repair damage caused by arthritis, a sports injury, or other hip conditions. 2018 Feb;28(2):255-267. Postoperative complications are the same for both approaches, including risk to structures, blood clots, infection, death, anesthesia risks. Anterior hip replacement surgery has lower rates of hip dislocation, but full posterior surgery has higher dislocation rates. With the anterior approach, detaching muscles is not required … The big difference in anterior vs posterior hip replacement is primarily where the incision is made and how long it is. This is done by making an incision through the back of the hip while the patient lies on their side. There are risks and benefits to each type of approach. The location of the incision determines the where the postsurgical scar will be. Less commonly, the incision is made horizontally. Veritas Health, LLC, Technique allows excellent visual exposure of hip cup, but challenging exposure of femur requiring muscle and capsule release. The incision used in this posterolateral approach, as it is called, is about six to nine inches long and is made along the side of the hip and the upper thigh. The top of your femur is shaped like a ball and covered with cartilage. The anterior approach (through the front of the hip) has been utilized as long as the posterior approach but its popularity has grown in the US over the past 10-15 years. Patients should find a surgeon very experienced in this approach. But because the posterior approach cuts through the muscles, there’s a higher risk of dislocation following surgery, typically within the first year. Comparison of direct anterior, lateral, posterior and posterior-2 approaches in total hip arthroplasty: network meta-analysis Eur J Orthop Surg Traumatol . Typically discontinue use of walking device 1-3 weeks sooner than posterior approach. He elaborates, "the anterior approach involves a true internervous/ intermuscular plane. Due to risk of nerve damage, the incision enters the compartment of the tensor fascia latae muscle to expose the hip safely. 60015. prime The majority of patients are a candidate for this type of surgery. To compare the outcomes of the direct anterior approach (DAA) with the lateral approach (LA) for total hip arthroplasty (THA) patients. The tensor fascia lata, which is a wide piece of fibrous soft tissue at the top of the outer thigh. Technique allows the surgeon full visualization if the hip cup and femur. See Total Hip Replacement Surgical Procedure. Because of the technical difficulty associated with anterior hip replacement, adequate surgical training is essential. Hyperuricemia - High Uric Acid Levels and Gout, Dietary Supplements for Treating Arthritis. The external rotators of the hip, which are small, short muscles that connect the top of the femur to the pelvis. Understanding the differences between these surgeries can help people decide what surgery, if any, is right for them. The gluteus maximus allows a person to extend and rotate the thigh outward. During this traditional approach, the orthopedic surgeon makes an 8-10 inch while you lie on your side. That should give you an idea of the recovery time involved. Surgical tools and tables have been developed to accommodate anterior hip replacement surgery and make the procedure easier for surgeons. Like the posterior approach, the direct lateral approach to hip replacement also requires the cutting of muscles. You may need a front-wheeled walker, cane, leg lifter, grab bars, and an elevated toilet seat. However, the rate limiting step in recovery from hip replacement surgery, be it via an Anterior or Posterior Approach, is the 6-8 weeks it takes the bone to “heal” to the implant. October 22, 2019 by Herman Botero, MD. Very small (less than 1%) risk of sciatic nerve damage from excessive retraction during surgery. Candidates for this approach are not significantly overweight, have no femur deformities, and normal pelvis anatomy. It is the most common approach and provides the greatest patient safety. It works with the iliotibial band (IT band) to help stabilize the hip and knee. 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