Anterior Approach

The anterior approach involves reaching the hip joint through a natural gap in the muscles at the front of the leg.  Here we look at the advantages and disadvantages of this approach.

The term 'surgical approach' refers to the place on your hip that the surgeon uses to access your hip joint

Advantages of the Anterior Approach

Proponents of the frontal approach argue that: -

  • it involves a shorter stay in hospital- normally just 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
  • with fewer muscles being cut there 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 discrepancy following surgery

Disadvantages of the Anterior Approach

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. This makes it difficult for the surgeon to know how much force is being exerted during the procedure and as a result an increase in  hip fractures have been reported to occur during the procedure.

The HANA Operating Table

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More recently some surgeons have withdrawn from using the technique.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.

Learn more about:

Different types of Anesthetics
Different types of Hip Implants 
The debate around the Best Time for Hip Replacement Surgery

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