Experiences with Anterior Total Hip Replacement

Wow…..it’s been nearly a year since we began performing anterior hip replacements at Johnston-Willis Hospital. I made a commitment to this new technique in an attempt to shorten the recovery period for patients after hip replacement. The hospital has also made a significant commitment by purchasing a dedicated Hana Table (specifically designed for anterior total hip replacement). We have also developed a dedicated team in the operating room which dramatically improves patient outcomes. So, now with much more experience what have I seen and what conclusions can we make?

First, I have noticed shorter recovery times and earlier mobilization for appropriate patients. Patients appear to have less pain, use less pain medication, and feel as though they are ready to return to activity more quickly. I believe that MOST patients can benefit from anterior approach hip replacement.

Second, I have noticed that not all patients are great candidates for the anterior approach. In some cases a posterior approach can be superior. An example would be patients with excessive skin or adipose tissue around the incision site which could lead to wound problems. Another example is a patient with hip dysplasia.

Finally, this is a technically demanding procedure. Inexperience in joint replacement can lead to significant complications. This procedure should not be performed by surgeons who are not accomplished in hip replacement. The learning curve is steep. Fellowship training or extensive experience in joint replacement is recommended.

In summary, anterior approach hip replacement has been a success. The procedure is now commonplace for our team and our hospital. We are very pleased to see our patients benefiting from this new technology!

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