Anterior Hip Replacement
Anterior hip replacement is a minimally invasive surgery performed to replace hip joint without detachment of any hip muscles because of which it is also referred to as muscle sparing surgery. The procedure involves a small incision made in front or anterior portion of the hip and is indicated in patients with arthritis of the hip joint.
Anterior Hip replacement may be indicated for the following conditions:
- Hip Arthritis
- Hip pain
- Stiffness and limited hip movement
Arthritis is a condition that occurs if the articular cartilage that covers the joint surface is damaged or worn out and as a result, the bone ends rub against each other causing pain and inflammation. Some of the causes of arthritis include:
- Childhood disorders such as Perthes disease and dislocated hip
- Increased stress on hip because of overuse
Patients with arthritis may have a thinner articular cartilage lining, narrow joint space, bone spurs or excessive bone may build around the edges of hip joint. Because of all these factors you may have pain, stiffness, and restricted movements of the hip joint.
Your doctor will evaluate arthritis based on your medical history and physical examination. X-ray may be required to confirm the condition.
Anterior hip replacement surgery involves the following steps:
- The procedure is performed under general anesthesia or regional anesthesia.
- During the procedure, you will be made to lie down on your back, on a special operating table that makes operating from the front of the hip possible.
- Your surgeon may use fluoroscopic imaging during the surgery to ensure that the artificial component used is correctly positioned. It also helps in minimizing leg length inequality.
- Your surgeon will make an incision, about 4 inches long on front side of the hip. Then the muscles are pushed aside to gain access to the hip joint and perform hip replacement.
- The femur bone is separated from the acetabular socket. The acetabular surface is prepared using a special instrument called a reamer, which creates a rough surface inside the acetabular socket so that the new component sits inside the socket.
- The acetabular component is cemented or fixed with screws into the socket. Then an acetabular liner made up of plastic, metal, or ceramic is placed inside the acetabular component.
- The femur head that is worn out is cut off and the femur bone is prepared using special instruments so that the new metal component fits the bone properly.
- Then the new femoral component is inserted into the femur bone either by press fit or by using special bone cement.
- The femoral head component made up of ceramic or a metal is fixed to the femoral stem that was inserted into the femur bone.
- Once the artificial components are in place, the instruments are withdrawn and incisions are closed with sutures and covered with sterile dressing.
Risks and complications
Although no major complications occur following anterior hip replacement surgery, there may be some risks involved with the surgery that include:
- Infection at the incision site or in the joint space
- Nerve damage
- Hemarthrosis-excess bleeding into the joint may occur after the surgery
- Deep vein thrombosis, clots can form in the calf muscle which may travel up to lung causing pain and difficulty in breathing (pulmonary embolism).
- Leg length inequality
After the surgery, your doctor will advise you certain precautions to be followed at home which will help in faster recovery. The post-operative instructions include:
- Take medications as prescribed to relieve pain and prevent infection
- Rehabilitation program which consists of exercises that will help in controlling pain, strengthen the stiffened muscles, and restore the normal movement of the hip joint.
- Eat a healthy diet and quit smoking as it will facilitate healing and promote faster recovery.
Contact your doctor if you observe swelling and redness in the operated area.
Anterior hip replacement approach has a lower risk of dislocation post-operatively and since it is a muscle-sparing technique, it ensures speedy recovery and lesser discomfort. On the other hand, it also allows patients use their hip joint normally without any restrictions.
Talk to your doctor if you have any concerns regarding anterior hip replacement.