Direct Anterior Approach for Total Hip Replacement is a new approach to Hip Replacement. Anterior or “from the front” hip replacement, is a minimally invasive technique developed by surgeons in France and Germany. It causes less trauma to muscle and soft tissue, less blood loss, and enables the patient to recover more quickly.
Because no muscle is damaged during the procedure, there is also less risk of the hip dislocating, compared to other techniques. Patients also walk without out a crutch, cane, or walker at a sooner point compared to other techniques. Patients can return to work 3-6 weeks after the surgery depending on the type of work performed.
Problems With the Posterior Approach
Most surgeons in the United States are trained in the posterior, or “from the back” approach to replace the hip joint. In order to do a replacement from the posterior or back approach, the surgeon must cut through the gluteus maximus muscle and three other muscles to get access to the hip joint. This causes muscle damage and trauma to the soft tissues around the hip. It also compromises the stability of the joint and has a higher dislocation rate.
The anterior approach or “from the front”, avoids these problems by avoiding damage to the surrounding hip muscles.
Several of our surgeons have traveled to France to learn the direct anterior approach from one of the world’s great hip replacement experts Frederick Loud. Our doctors have adopted these European techniques into their practices and helped hundreds of patients enjoy faster recoveries due to this procedure.
Special instruments and an innovative operating room table are utilized for anterior hip replacement. During the procedure, a portable x-ray machine is used to ensure that the parts are put in correctly to match the patient’s anatomy and ensure that the leg lengths are equal.
Is the Anterior Approach Right for You?
Although the vast majority of our hip replacements are done from the anterior approach, some hips are better replaced from the posterior approach. Hip replacement revisions are often done from the posterior approach for better access to the femoral canal. Some childhood hip diseases such as dysplasia and Perthes disease are best treated by posterior approach due to some of the complex deformities that are often present.
The benefits of the Direct Anterior Approach for total hip replacement include:
- Lower dislocation rates
- More precise replication of leg length
- A safer procedure
- Improved early recovery and return to normal activities
Through the use of new equipment and technology, patients suffering from debilitating hip pain now have a new option for relief. Davis Hospital has recently purchased a Hana table which allows patients to be positioned on their back (or supine) during surgery, making it possible to replace the hip safely through a single incision. Dr. Lyman has received extensive training in the Anterior Supine Intramuscular (Direct Anterior Approach for Total Hip Replacement) approach to hip replacement and is currently using this special table to improve his patients’ lives. (Do our other hip surgeons use the Hana table?)
The Direct Anterior Approach for Total Hip Replacement is unique because it is done without detachment of muscle from the pelvis or femur. The use of the Hana table allows the surgeon to place the leg in any position. By utilizing multiple positions, the components of hip replacement can be implanted through the anterior, or front, of the hip providing immediate stability of the hip after surgery and reducing the risk of hip dislocation.