TOTAL HIP REPLACEMENT WITH NO LIMITATIONS- THE DIRECT ANTERIOR APPROACH
What is total hip replacement?
A total hip replacement is a type of surgery. It replaces your hip joint with an artificial one. It is also called total hip arthroplasty.
Your hip is a ball-and-socket joint. Your thighbone (femur) bends inward near the hip. The upper end (head) has a round shape. The neck is the part that bends inward. The shaft is the long straight part.
An orthopedic surgeon does hip replacement surgery to replace a damaged hip joint. During the surgery, the surgeon will replace parts of your hip joint with artificial parts. The ball side of the Hip will be replaced with metallic or ceramic ball. On the socket side, we replace with a shell and a liner which represents articular cartilage. The surgery also eases pain and helps improve movement.
An orthopedic surgeon can do these procedures from behind the hip, to the side of the hip, or from in front of the hip. Total hip replacement with anterior approach refers to surgeries done from in front of the hip. These surgeries may also be called mini, modified, minimally invasive, or muscle-sparing surgeries.
The Direct Anterior Approach for total hip replacement is a tissue-sparing alternative to traditional hip replacement surgery that provides the potential for less pain, faster recovery and improved mobility because the muscle tissues are spared during the surgical procedure. The technique allows the surgeon to work between muscles and tissues without detaching them from either the hip or thighbones – avoiding trauma to the tissues.
Compared to traditional hip replacement, which involves an 8 to 12-inch incision from the side or back, the direct anterior total hip replacement is a front (anterior) approach with a smaller incision, three to four inches long. Whenever a hip replacement surgery performed through Direct Anterior Approach, it is not necessary to cut any muscles or tendons around the hip. This means that patients have more freedom of movement after surgery and leg lengths are equal at the end of surgery. Also, dislocation rates are lower and recovery is faster and less painful.
We use a highly specialized operating table allowing X-rays to be obtained during the surgery. This ensures precise placement of the implants, resulting in more functional hip mechanics and equal leg lengths
Benefits of Direct Anterior Approach for the Patient
No restriction of post-op activity including sitting cross legged, or squatting
Minimal risk of dislocation
Reduced tissue trauma
Less pain, meaning less pain medication
Faster recovery
Little or no physical rehabilitation
Earlier release from hospital
More accurate leg lengths and alignment with intra-operative X-ray
Preservation of the hip musculature
No hip precautions after surgery
Minimal scarring
Patients may walk same day as surgery
Limitations Of Direct Anterior Approach
Limited utility in severely obese patients
How Long will the operation take?
The operation takes around 45-60 minutes and the patient is allowed to start walking the next day morning. Due to good pain management, hip replacement has become a painless operation, hence they have very rapid recovery. The patients will be given walking, toilet training within the shortest time and can be discharged on the third or fourth day itself. The recovery period is around 4 to 6 weeks after which they can join their normal duties.
What are the do’s and don’ts?
With Direct anterior approach as compared to the traditional approach the advantage is that the patient will have minimal limitations in performing daily activities including sitting cross legged and squatting. However the patient should avoid activities such as contact sports which has a chance of getting injured which might lead to damage to the joint. The patient will be back to normal life without any limitations within a period of 4 to 6 weeks.
Shalby Hospitals is one of the leading joint replacement centers for knee, hip & shoulder. The operation is done in state of the art operating theatre with laminar flow and wearing space suits to avoid infections. Our surgeon Dr Vikas Jain is trained internationally in performing hip replacements with direct anterior approach.
Dr Vikas Jain
MBBS, MS Orthopedic, Fellowship Joint replacements- Lisbon, Europe
Consultant Joint replacement- Shalby Hospitals, Indore
