Finding the right Hip Replacement Surgery for you

There are so many options available today for hip replacement surgery.  You no longer have to choose traditional hip replacement surgery with longer recovery time and many activity restrictions.  There are two other hip replacement options now available from certain specially trained surgeons.  Besides the traditional posterior hip replacement, you can also choose to have the anterior or direct anterior hip replacement.

Traditional hip replacement surgery is done by a surgeon who has been trained in the posterior approach.  The posterior approach goes through the posterior(or back) of the hip joint.  The incision is made close to the buttock and the small tendons and joint capsule behind the hip joint or temporarily detached.  These are reattached after the joint is replaced.  Advantages to this surgery include:  a proven successful track record and low complication rate.  Disadvantages are higher rate of hip dislocation risk after surgery and several activity restrictions.  The restrictions for this surgery are no crossing the legs, no bending past the waist, and not pointing the toes inward.  If these restrictions are not acceptable to you, there are other options.

Many surgeons are getting extra training and learning how to perform the anterior approach also called anterolateral approach.  This surgery requires the surgeon to make a small incision on the side of the leg rather than the back.  The surgeon does not have to cut any muscles or tendons.  The muscles are moved and reattached after surgery.  Advantages over posterior surgery is that there are less restrictions, faster recovery time, and less risk of hip dislocation.  Disadvantages include slightly higher femoral and ankle fractures during surgery and damage to the nerve that runs along the thigh.  

There is also a brand new technique that is gaining popularity called the direct anterior approach.  This approach goes through the front of the hip joint by an incision made in the front of the leg.  The surgeon does not have to cut or detach any muscles or tendons.  This technique is more complicated and the surgeon must be able to use special instrumentation to see the hip joint.  Advantages to this surgery include no muscle or tendon movement and therefore no activity restrictions, little to no risk of hip dislocation, and most patients are able to leave on the second day after surgery.  Patients are usually able to walk without crutches or walker by the second week after surgery because the recovery time is expedited.  Disadvantages include the challenge of viewing the hip joint during surgery.  This surgery requires more training for the surgeon and may take the surgeon many surgeries in order to master the process.  Many newer surgeons are learning this technique in residency which allows them the time to practice.

There are three options for hip replacement surgery to choose from.  Make sure to do your research and talk to your doctor about which technique is right for you.  You can go on-line and look at the surgeon’s bio in order to see which technique they are able to do.