Direct Anterior Total Hip Arthroplasty

The hip is a ball-and-socket joint where the ball at the top of the thigh bone, or femur, fits inside the socket, or acetabulum, in the pelvis. A natural substance in the body called cartilage lubricates the joint. When the bone and/or cartilage of the hip become diseased or damaged from arthritis, hip fractures, bone death or other causes, the joint can stiffen and be very painful. A total hip arthroplasty, or joint replacement, may be recommended for patients who experience severe hip pain and whose daily lives are affected by their symptoms.

Initial treatment for advanced hip conditions often includes nonsurgical techniques such as medication, physical therapy and using assistive devices such as orthotics or a cane. If these methods are unsuccessful, surgery will often be recommended to relieve the symptoms and help patients to resume a more active, comfortable lifestyle.

Total hip arthroplasty involves replacing the diseased bone and cartilage with synthetic implants to relieve pain and restore movement and function to the joint. After this procedure, patients will be able to once again move without the stiff, debilitating pain of arthritis.

Advantages of Direct Anterior Total Hip Arthroplasty

New technology has allowed for certain minimally invasive techniques to be employed during the hip replacement procedure. When a patient requires a hip replacement surgery, the traditional method involves reaching the joint through the rear of the leg. But recent advances in technique have made an anterior approach a better solution for certain patients. In a direct anterior total hip arthroplasty, the surgeon accesses the hip joint through the front of the leg instead. The surgery is performed under general anesthesia and lasts between two and four hours, followed by another few hours spent under observation in a recovery room.

Entering the joint through an anterior approach offers a number of advantages. Muscles that need to be cut and subsequently reattached for traditional hip replacement surgeries only need to be moved aside for anterior hip arthroplasty. An anterior hip replacement provides the surgeon with the ability to clearly visualize the full hip socket and allows for a variety of implant devices to be introduced.

This minimally invasive technique can lower the risk of dislocation that is more common in other hip replacement procedures. By maintaining the integrity of the muscles and the hip capsule, it also provides the stability necessary to avoid leg lengthening. Therefore, there is a much better chance of keeping both leg lengths precisely equal.

Determining Candidacy for Direct Anterior Total Hip Arthroplasty

The direct anterior total hip arthroplasty procedure may not be well suited to certain patients. Those with prior implants in the hip, some particularly muscular individuals and patients who are obese may not be ideal candidates for this type of hip replacement approach. After a physical examination and analysis of a patient’s condition, the doctor can determine whether anterior hip arthroplasty would be the best form of treatment in that particular case.

Recovery from Direct Anterior Total Hip Arthroplasty

Since less muscle damage takes place, direct anterior total hip arthroplasty often enables the patient to be hospitalized for a shorter period of time and to recover more quickly. In many cases, patients can walk without the use of an assistive device in two to three weeks post-surgery. Low-impact forms of exercise are recommended immediately after anterior hip replacement, and higher-impact activities are typically only prohibited for three months.

Pain medication may be prescribed to manage any mild discomfort, swelling or bruising in the hip region during the recovery process. Hip arthroplasty produces immediate pain relief from arthritis or other degenerative conditions.

Risks of Direct Anterior Total Hip Arthroplasty

The risks associated with total hip replacement are considered rare but may include infection, blood clots, fracture, loosening of the new joint, stiffness and more. The chance of complications developing can be reduced by choosing an experienced surgeon to perform the procedure, and by adhering to the surgeon's instructions before and after surgery.