Modified Anterolateral Approach

The modified anterolateral approach is the most commonly used approach in contemporary hip replacement surgery.

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

Advantages of the 
Modified Anterolateral Approach

  • It is relatively quick
  • The amount of blood lost is less than with some other approaches (i.e. anterior and trochanteric)
  • The rate of post-operative dislocation is low
  • Rehabilitation is quick
  • The patient will have a good range of movement

Disadvantages of the
Modified Anterolateral Approach

  • Access to the joint is not as good as in the original lateral approach (which involved removal of the trochanteric)
  • There is some risk of damage to the superior gluteal nerve
  • There is a risk of post-operative muscle weakness causing abduction and a limp

How Is the Modified Anterolateral Approach Carried Out?

The patient is placed on her side and a straight incision of about 10 centimetres is made down the thigh centred on the greater trochanter (this is the 'bump' you can feel if you run your palm down the outside of your thigh.

The muscles beneath the incision (the gluteus medius and the vastus lateralis) are then cut along the length of the fibres, exposing the joint capsule. The capsule can then be cut open and the hip joint replaced.

Want to watch the operation?

The following link will take you to a YouTube video showing the preliminary stages of the surgery. It doesn't show the hip being replaced but how the surgeon approaches the hip in order to replace it. 

*WARNING* It is not for the squeamish as its a real-life operation.  

Modified antero-lateral approach video

The modified anterolateral approach is just one way that a surgeon can perform a hip replacement.  Some surgeons seem to prefer to use one approach over the others but they all will take into account considerations like your medical history, the presenting problem, your age, weight and mobility.

Learning about the different approaches will enable you to have an informed discussion with your surgeon but you may not get to pick! However, your surgeon should explain why he thinks a particular approach will benefit you over the others.

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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