Anterior Hip Replacement in DC

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Anterior Hip Replacement

Anterior hip replacement is a technique that is a dramatic improvement in surgery.

Anterior hip replacement is a significant improvement from posterior hip replacement.  Most hip replacements in the United States are done using a posterior approach technique.  In a posterior approach, the incision is made in the back, muscles and tendons are cut, and the hip joint is exposed.  The ball and socket are replaced with a metal and plastic prosthesis.  The procedure does not allow for x-rays or guidance.

In an anterior hip replacement, surgery is done from the front.  Muscles are spread but not cut.  In addition, the surgery is done under x-ray navigation guidance, which allows the metal prosthesis to be placed precisely with regards to the patient’s existing anatomy.

Anterior hip replacement has faster recovery, lower risk of complications, and generally improved outcomes.  Because the surgery is done without cutting muscles and done with x-rays during surgery, results are better.

Why doesn’t everyone do anterior hip replacement?

The answer is that the surgery more technically challenging and requires more training.  Many surgeons are not yet familiar with or able to use an anterior technique

Where should I go for my hip replacement?

You should go to a hospital that does a lot of hip replacements.  Several studies have analyzed the risk of complications and the outcomes after total hip replacements.  The evidence shows that hospitals that do a lot of joint replacements are the best places to go because they have the least complications.  There is something about doing the same procedure over and over again, which leads to higher quality outcomes.

I operate exclusively out of Suburban Hospital (part of Johns Hopkins), which does the most total joint replacements in the state of Maryland.  Almost 1,000 per year.  A high volume center is a place where high-quality outcomes can be expected.

What is new in hip replacement in 2019?

2019 hip replacement is faster, more predictable, and has a faster recovery.

Just a few years ago a total hip replacement was a one week stay in the hospital, extensive rehabilitation, and significant amounts of narcotic pain medications.

Thanks to the anterior approach, which does not cut any nerves, pain after surgery is significantly diminished and recovery is much faster.  Because fewer precautions are required physical therapy can begin immediately, and patients can be out of bed even the same day.  Anterior hip replacement truly is a major innovation in orthopedic surgery.

A few years ago there were quite a few difficulties with metal-on-metal total joint replacements.  These problems have been eliminated because they are no longer using the implants that were associated with problems.  High-quality metal-on-polyethylene hip replacements can be quite durable.  Recent studies have shown up to 80% of hip replacements are functioning well 15 years after surgery.  In 2019, there is really no reason to suffer with hip arthritis.