by Alexander Harbin, MD

Hip replacement is one of the most commonly performed surgeries worldwide. It has helped restore the quality of life for millions of patients since the 1960s. Since that time implant design and longevity have improved dramatically. Recently, significant advancements have been made in surgical technique and pain control. This has allowed us to reduce the length of hospital stay from many days to less than one day for many people. The progress made with anterior hip replacement has been a large factor in allowing people to return to a normal lifestyle as quickly as possible.

While there are many reasons we perform hip replacements, osteoarthritis is by far the most common. This is when a patient has worn out the cartilage in the joint. Commonly, people refer to this as, “bone on bone arthritis.” For patients, this often manifests as pain with ambulation or activity, which is located in the groin region. Many patients also notice increasing difficulty with daily activities such as putting on shoes and socks and getting in and out of the car. As a patients’ arthritis progresses, hip replacement often becomes the best option to restore quality of life.

Numerous techniques exist to perform a hip replacement, and nearly all have seen success. I believe anterior hip replacement gives patients the best result, with as little recovery and complications as possible. The approach for anterior hip utilizes an incision in front of the hip, going between muscles, instead of through muscles, to gain access to the hip joint itself. Once there, the arthritic joint is replaced with titanium, ceramic, and plastic, allowing it to function more normally.

You may ask, “Does approach matter when performing hip replacement?” There are several advantages to anterior hip replacement. Generally, an anterior hip replacement can be performed through a smaller incision. This may allow quicker and less painful recovery than other techniques, and allow patients to return home more quickly. Another major advantage is reduced postoperative precautions due to a lesser chance of the hip replacement coming out of the socket, or dislocating. To prevent dislocation after other techniques, hip precautions are utilized. This means patients may be asked to avoid flexing the hip past 90 degrees, sitting in low chairs, or crossing their legs for some period of time postoperatively. A hip performed through an anterior approach avoids the need for these precautions, allowing patients to focus more on their recovery.

Improvements in surgical and anesthetic techniques have allowed patients and their surgeons to be more comfortable with shorter or even no hospital stay. This may also give patients the option to have their surgery at an ambulatory surgery center, avoiding the hospital completely in many circumstances.

There is always a risk with surgery, despite the technique utilized. Hip replacement is only rarely the initial recommended treatment course. It is important to discuss with your surgeon your quality of life and what you have done to treat your pain. When it does come time to proceed with a hip replacement, the anterior approach may provide a quicker and more comfortable surgical experience, an advantage most patients find appealing.

Alexander Harbin

Alexander Harbin is a Board Certified, fellowship-trained Surgeon from the Bone and Joint Center in Albany, NY specializing in hip and knee arthroplasty. Please call 518- 489-2666 to schedule a consultation with Dr. Harbin.