From an interview with
Dr. Christopher Walsh
McLeod Orthopaedics Seacoast
Although hip replacement surgery with the incision from the front has been around for a while, this so-called anterior approach has become increasingly popular. McLeod Orthopedic Surgeon Dr. Christopher Walsh explains two basic approaches to hip joint replacement and a main advantage of the anterior approach.
Here’s a summary of Dr. Walsh’s comments:
There are basic approaches to the hip. One is the posterior approach, which is the workhorse approach, the gold standard approach. Then, there’s the anterior approach, which has gained a lot of popularity over the last 10-15 years.
The anterior approach is an incision through the front of the hip. The incision is usually 6 to 8 centimeters long, whereas the posterior approach incision is a bit longer, because the surgeon needs more space to work. With an anterior approach, you are pushing the muscles to the side and not really cutting through any tendons or any muscles in order to access the hip. For the posterior approach, there are some muscles that you do need to detach in order to get down to the hip joint itself.
With the posterior approach, you are limited in your hip “precautions” for 6 weeks after surgery. Hip precautions after surgery are a couple positions that we want the patient to avoid while recovering after surgery — mostly increased flexion of the hip with external rotation of the hip. That puts the patient at risk for dislocation during the healing process of the posterior approach incision.
With the anterior approach, you’re able to do any and all activities right after surgery.
McLeod’s Total Joint Program encompasses both the preoperative and the post-operative aspects of surgery. It starts a couple weeks before the surgery with joint classes. Patients receive their preoperative testing so that the transition to the recovery floor after surgery is very smooth. Additionally, we’ve worked extensively with our anesthesiologists to maximize a patient’s recovery, enabling patients to get up and walking the same day after surgery. Patients receive physical therapy twice the day of surgery and twice the day after surgery with the majority of our patients going home that first post-operative day.
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