Home: Hip Replacement Approaches | Anterior Approach

Anterior Approach

The anterior approach involves reaching the hip joint through a natural interval in the muscles at the front of the leg.

Advantages

Proponents of the frontal approach argue that: -

it involves a shorter stay in hospital- normally 2-5 days
rehabilitation times are reduced as no muscle is detached from either the pelvis or the femur and the gluteal muscles, which are the most important muscles involved in working the hip are not cut
in turn this means there is less chance of a dislocation following surgery
patients do not need to follow the usual course of hip precautions that lateral and posterior approach patients must do
the incision used is usually smaller
there is less chance of a leg length discrepency following surgery

Advantages

Proponents of the frontal approach argue that: -

it involves a shorter stay in hospital- normally 2-5 days
rehabilitation times are reduced as no muscle is detached from either the pelvis or the femur and the gluteal muscles, which are the most important muscles involved in working the hip are not cut
in turn this means there is less chance of a dislocation following surgery
patients do not need to follow the usual course of hip precautions that lateral and posterior approach patients must do
the incision used is usually smaller
there is less chance of a leg length discrepency following surgery

Disadvantages

A special operating table is required to perform the operation with the patients legs attached to the table. The table is then turned to allow the prosthesis to be inserted. As it is difficult for the surgeon to know how much force is being exerted hip fractures have been reported to occur during the procedure.
X-ray equipment is used to ensure correct alignment of the implant. If the X-ray equipment is not positioned correctly there is an increased risk of the implant being badly positioned,
It is possible that damage may occur to surrounding muscles or nerves during the insertion of the implant
More recently some surgeons have withdrawn from using the technique. Partly because a minimally invasive approach means the surgeon finds it harder to see and feel what he is doing and partly because there are concerns about revision rates.

I should also add that although the initial recovery period is quicker with the anterior approach other patients soon catch up and after a few months there is no difference in progress.

How Is It Done?

Surgery is easier to understand visually than verbally so here is a great little video of the procedure. Its graphical video not one of a live operation.