Anterior approach to hip replacements preserves tissue, speeds recovery

Published: Feb. 12, 2016 at 10:39 AM CST|Updated: Feb. 12, 2016 at 10:45 AM CST
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The number of hip replacements performed in the United States has more than doubled from year 2000 to 2010, according to the U.S. National Center for Health Statistics.

Lake Area Medical Center orthopedic surgeon, Dr. Alan Hinton, says although the surgery is effective, the traditional approach of going beside or behind the hip joint, cutting through muscle, has had its flaws.

"The problem with that is the pelvis kind of wobbles back and forth while you're doing the surgery," said Dr. Hinton, "so it makes it a little difficult to put the cup part of the implant in the correct position."

Dr. Hinton says a newer technique known as the anterior approach, allows the surgeon to work between muscles and tissues while using the Hana table for a heightened range of motion.

"Rather than going through the back of the hip through muscle or through the side, also through muscle, where you have to split muscle, doing an anterior approach we just move the muscles out of the way," said Dr. Hinton.  "It makes for a quicker recovery and a little bit less pain for the patient."

Charline Andrepont of Carlyss can agree with that.  She only spent one night in the hospital after undergoing the anterior approach hip replacement, the first at this hospital.

"I was just wanting to get out of pain and if it took this to get me out of pain, I was willing to do it," said Andrepont.

Once the patient is in the operating room, he or she will be put onto the Hana table and the feet will be buckled into the traction boots.  At that point, the surgeon can direct the manipulation of the operative leg.

"We're able to lay the patient flat, so that their pelvis doesn't tilt and we can take intraoperative X-rays, real-time X-rays, of both hips and we can compare the length very, very accurately and also position the cup very, very accurately," said Dr. Hinton.

The cup positioning is critically important to a good outcome.

"If the cup is in the wrong position, the hip can pop out of socket or it can even make the leg too long, where the patient's leg is actually an inch or so longer than the other leg," said Dr. Hinton.

Andrepont is about three months post surgery today and says she is feeling great.  For her, that change meant becoming like herself again, after several months being home-bound because of the pain.

"When I felt like I wanted to get my clothes on and I did it all by myself, that's when I knew I was doing so much better," she said.

The incision for the anterior approach is about four to five inches long.  Traditional hip replacement incisions are about eight inches long.

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