Anterior Approach Hip Replacement
Total Hip Replacement
Once you have arthritis which has not responded to conservative treatment, you may well be a candidate for total hip replacement surgery.
Other causes include
In an Arthritic Hip
You should consider a THR when you have:
The decision to proceed with THR surgery is a cooperative one between you, your surgeon, family and your local doctor. Benefits of surgery include:
Day of your surgery
Once you are stable and awake you will be taken back to the ward.You will have one drip in your arm for fluids.
The day of surgery we aim to get patients up and walking with the physical therapy. Pain is normal but if you are in a lot of pain, inform your nurse.
You will be able to put all your weight on your hip and your Physiotherapist will help you with the post-op hip exercises.
The majority of patients spend 1-3 nights in the hospital and the duration depends on how well you do in the hospital.
Sutures are usually dissolvable but if not are removed at about 10 days.
A post-operative visit will be arranged prior to your discharge.
The rehabilitation following surgery usually entails working with a physical therapist while in the hospital. For the first 2 weeks following discharge we encourage you to walk and mobilize at home without home health services; however, in select cases we will encourage either home health services or a short stay at a rehabilitation center. Patients start seeing a physical therapist in an outpatient setting at about 2 weeks following your hip replacement.
The acetabulum (socket) is prepared using a special instrument called a reamer. The acetabular component is then inserted into the socket. This is sometimes reinforced with screws or occasionally cemented. A liner which can be made of plastic, metal or ceramic material is then placed inside the acetabular component.
The femur (thigh bone) is then prepared. The femoral head which is arthritic is cut off and the bone prepared using special instruments, to exactly fit the new metal femoral component. The femoral component is then inserted into the femur. This may be press fit relying on bone to grow into it or cemented depending on a number of factors such as bone quality and surgeon’s preference.
The real femoral head component is then placed on the femoral stem. This can be made of metal or ceramic.
The hip is then reduced again, for the last time.
The muscles and soft tissues are then closed carefully.
Risks and complications
It is important that you are informed of these risks before the surgery takes place.
Complications can be medical (general) or specific to the hip
Medical Complications include those of the anesthetic and your general well being. Almost any medical condition can occur so this list is not complete.
Specific complications include
Anterior Hip Replacement
The direct anterior approach utilizes a muscle interval in front of the hip joint in which muscles and tendons are not cut for exposure of the joint. Because exposure can be more challenging, special instruments and a custom operating table are used to assist in performing the surgery.
Patients who have undergone Direct Anterior Hip Replacement surgery report that the post-operative pain and discomfort is markedly less than traditional approaches. In addition, their recovery is expedited. Most patients are discharged from the hospital by post op day #2 and are off of all walking aids (cane/crutches) by the 2nd week from surgery.
The Direct Anterior Approach is not applicable to all patients. Most patients who are undergoing Revision Total Hip Arthroplasty will be better served by more traditional approaches. Those patients who have hip deformities from childhood also, on occasion, are not candidates for the direct anterior approach.