Hip replacement can be performed in two primary ways: traditional (called open surgery) or a minimally invasive technique known as the anterior approach. The main difference between these procedures is the size and location of the incision.
Traditional open hip replacement was the standard for decades. With the traditional approach, the surgeon makes one large eight to ten inch incision along the side of the hip. During the surgery, the doctor works through that larger incision to move the muscles to the side, exposing the joint. The ball portion of the joint is cut away and an artificial ball joint is cemented to the thigh bone. The surface of the hipbone is cleaned by removing damaged or worn-out cartilage and then the replacement artificial socket is connected to the hipbone. Finally, the ball is inserted into the new socket. A drain may be inserted to aid healing. Finally, the leg muscles are returned to their normal position and the incision is closed.
Anterior hip replacement is a minimally invasive procedure that uses a small incision, spares muscle tissue and has patients back home to begin recovery within a few hours.
Patients like Bob can literally have the surgery in the morning and be home recovering by lunchtime. Instead of making one large incision, surgeons make one to two small cuts from two to five inches long. Instead of working from the back of the hip (the posterior position), the surgeon works from the anterior (front) of the leg. The same procedure can be completed through these smaller openings. This reduces blood loss, speeds healing, reduces scarring, improves range of motion and gets the patient home much faster. The patient experiences less pain during recovery and anterior outpatient hip replacement can decrease downtime by several weeks.
After the anterior approach hip replacement, the patient is typically encouraged to get up and walk slowly as soon as they can within the safe confines of the outpatient surgery center. This movement enhances blood flow and reduces any risk of blood clots. Once home, there is a several week rehabilitation process that includes physical therapy to improve range of motion and strengthen the hip muscles. Most patients begin using a walker directly after the surgery, then switch to a cane, and finally resume walking on their own. Full recovery can happen within about a month to six weeks.
Bob’s experience with the first anterior outpatient total hip procedure was so positive he had the second just five months later. Today, he says, “I have zero pain in my hips now.”