Anterior Hip Replacement
The Anterior Hip Replacement is a form of hip replacement performed from the front of the hip as opposed to the traditional hip replacement done from the back (Posterior hip replacement) or side of the hip (Anterolateral hip replacement)
The Anterior Hip Replacement is a minimally-invasive technique preserving the muscle and soft tissue. In other words, there are no muscles or tendons cut in this form of hip replacement done through the anterior method.
The Anterior Hip Replacement procedure involves making a small incision in front of the hip joint, as opposed to an incision on the side or back of the hip which is done traditionally.
The incision for the Anterior Hip Replacement can either be vertical (standard anterior hip replacement) or a bikini incision Anterior Hip Replacement where the scar is in the groin crease hidden and is cosmetically pleasing.
The direct Anterior Hip Replacement is also called muscle sparing surgery or soft tissue preserving or minimally-invasive hip replacement, because no muscles are cut to access the hip joint, enabling a much quicker return to normal daily activities.
What does Anterior Hip Replacement surgery involve and where is the Anterior Hip Replacement cut?
The Anterior Hip Replacement cut is placed on the front of the hip, slightly angled towards the outer aspect of the thigh like the image shown below. ASIS (Anterior superior iliac spine – part of the pelvic bone)
Surgical steps of Anterior Hip Replacement
Once the skin incision is made, the plane between the muscles is identified. It is an inter-musclular and inter-nervous plane. The space between the 2 muscles sartorius and tensor fascia lata is opened without cutting any muscles or tendons.
The hip joint in the Anterior Hip Replacement is reached without actually cutting any muscles.
Anterior Hip Replacement surgery involves dissecting the deep and minimally-invasive tissue to expose the joint capsule. The hip joint capsule is then identified and opened to expose the hip joint. See below.
Anterior Hip Replacement surgery involves dissecting the deep and minimally-invasive tissue to expose the joint capsule. The hip joint capsule is then identified and opened to expose the hip joint. See below.
The Images below show photos of how the head and neck is resected in anterior hip replacement and how it looks. The head and resected part of the neck is
The femur is then prepared to put the femoral implant with specialized tools in anterior hip replacement
The special broaches is used to prepare the femur to achieve the right sized implant – See Below
The special broaches is used to prepare the femur to achieve the right sized implant – See Below
The Socket is then prepared in Anterior Hip Replacement with a special reamer of increasing sizes until the desired size is achieved as planned on Xray or computer. See below image – showing the reamed
Once the acetabulum (Socket) is prepared the cup is then inserted and placed into the appropriate position and in some cases surgeons use screws – See below.
The Femoral component is then inserted through the small incision of the anterior hip approach technique and impacted to the accurate depth.
The Femoral Head (Ball) is then inserted, the hip is reduced into place and the surgical wound is closed.
Once the patient is back on the ward, Xrays are performed – see below
The Advantages of Anteiror Hip Replacement include:
- Less post-surgical pain as muscles are not cut, less blood loss, less muscle weakness
- Early mobilisation (as early as 3-4 hours after surgery), rapid recovery
- Less risk of dislocations, early discharge home
- Drive within days to weeks after surgery