Anterior Total Hip Replacement

Talk with Your Hip Expert Today!

• Soft Tissue Sparing – Anterior approach avoids cutting the muscle, as it follows the natural path between the muscles.
• Smaller Incisions – Anterior approach to the hip is much closer to the hip joint, allowing for a smaller incision.
• Less Pain – Many patients do complain of pain on the day of surgery, and may not require more than Tylenol for pain control.
• No Posterior Hip Precautions – The traditional approaches require patients to avoid internally rotating the hip, or bending the hip past 90 degrees. This can be very limiting for patients during their recovery phase.
• Faster and Easier Recovery – Without posterior hip precautions and less pain after surgery, recovery is much faster
• Early Discharge From Hospital – Many patients are able to go home on the day of surgery
• Lower Risk of Hip Dislocation – More accurate positioning of implants during surgery allow for a lower risk of hip dislocation
• Equal Leg Lengths – Leg length discrepancy after surgery, especially in Hawaii (where people wear slippers or walk barefoot on the beach), can be a big deal. Intra-operative x-rays performed during the anterior hip surgery allow for more accurate placement of implants and avoid leg length issues.

Dr. Morton is an expert hip surgeon who is fellowship-trained in hip replacement surgery. Talk with him today about your hip problems!

Hip replacements involve the removal of the arthritic part of the hip. This means that the hip socket on the pelvis is resurfaced with metal, and the arthritic femoral head is removed and replaced with a ball and stem that is placed into the femur (thigh bone). There are many different approaches to the hip. The most common ways to approach the hip socket are through the posterior and anterior hip approaches

The traditional posterior surgical approach to total hip replacement goes through the back of the hip. This approach uses a single, long incision to get access to the hip joint. This incision cuts through the gluteus maximus muscle. The posterior hip replacement also requires the release of a small muscle group called the “short external rotators”. These muscles are important to the stability of your hip.

The anterior total hip arthroplasty works through an incision through the front of your thigh.  This incision is performed through a muscle-sparing approach. The approach does not cut any muscle, moving apart the muscle to get access to the hip joint. Specifically, the anterior approach is between the sartorius and iliotibial band muscles. The “short external rotator muscles” are not released, meaning that the hip is more stable.  The anterior approach may not be suitable for all patients. Your orthopedic surgeon will discuss different surgical approaches with you.

• Soft Tissue Sparing – Anterior approach avoids cutting the muscle, as it follows the natural path between the muscles.
• Smaller Incisions – Anterior approach to the hip is much closer to the hip joint, allowing for a smaller incision.
• Less Pain – Many patients do complain of pain on the day of surgery, and may not require more than Tylenol for pain control.
• No Posterior Hip Precautions – The traditional approaches require patients to avoid internally rotating the hip, or bending the hip past 90 degrees. This can be very limiting for patients during their recovery phase.
• Faster and Easier Recovery – Without posterior hip precautions and less pain after surgery, recovery is much faster
• Early Discharge From Hospital – Many patients are able to go home on the day of surgery
• Lower Risk of Hip Dislocation – More accurate positioning of implants during surgery allow for a lower risk of hip dislocation
• Equal Leg Lengths – Leg length discrepancy after surgery, especially in Hawaii (where people wear slippers or walk barefoot on the beach), can be a big deal. Intra-operative x-rays performed during the anterior hip surgery allow for more accurate placement of implants and avoid leg length issues.

A hip replacement is a good option for patients who have severe pain in their hip secondary to arthritis. Most patients with arthritis experience pain in their groin region. Sometimes this pain can be felt on the outside of their hip. Often times patients experience this pain as “knee pain”. It can often be difficult to tell when patients have pain that comes from their knee or their hip. Dr. Morton uses a combination of x-rays, physical exam, and diagnostic injections to help you determine what is contributing to your pain.

You should consider having a hip replacement when your hip causes enough pain that prevents you from enjoying your life and you have failed nonoperative treatment.

In general, most patients may undergo hip replacement from both approaches. The anterior total hip surgery is less suitable for patients who are overweight or have already undergone other hip surgeries in the past. Patients who have a significant deformity of the hip joint or with health problems that may slow wound healing may also be at high risk for poorer outcomes with the anterior total hip replacement. Call Dr. Morton to set up an appointment if you would like to see if you are a candidate for the anterior hip replacement.

Traditionally, many patients after the posterior total hip replacement complained of leg length inequality and pain to the outside of their hip.  Dr. Morton uses specialized tools such as x-ray during surgery to check leg-lengths intra-operatively.  Sometimes getting your leg lengths perfect can be harder to achieve during revision and deformity surgery.

During surgery, Dr. Morton also considers the offset of your hip. Offset is the measurement of how far your femur bone is from your pelvis bone.  The further away it is, the higher the offset.  A high offset can sometimes put increased pressure on the hip and cause pain. A low offset can cause an unstable hip.  Dr. Morton uses specialized tools to help figure out the appropriate offset of your hip. Talk with Dr. Morton about leg lengths and offset to understand how he will personalize placing your hip implant.

When deciding to have a hip replacement, you need to understand the limitations of your joint replacement surgery. Over 90% of people who have a total hip replacement have an incredible reduction in their hip pain and a dramatic improvement in returning to a better function. For most patients with normal use and activity, the hip replacement rarely wears out the plastic spacer. Dr. Morton likes to follow-up his patients on an annual basis with an x-ray to ensure that your hip replacement is continuing to function at the best of its ability. Increased activity or weight may speed up the wear and tear on your plastic components and may cause the hip replacement to loosen or become painful. After your recovery, you will feel like you can do many physical activities. The American Academy of Orthopaedic Surgeons advises our patients to avoid running, jogging, jumping or other high-impact activities with a hip replacement.