All about anterior hip replacement

Written in association with: Professor Richard Field
Published: | Updated: 12/09/2024
Edited by: Conor Lynch

Anterior hip replacement is a surgical procedure that involves replacing the hip joint through an incision at the front (anterior) of the hip. This approach is gaining popularity due to its potential benefits, including reduced recovery time and less postoperative pain.

 

Unlike traditional hip replacement methods that access the hip joint from the side (lateral) or back (posterior), the anterior approach allows surgeons to work between the muscles, avoiding the need to detach them from the hip or thigh bones. Here, renowned consultant orthopaedic surgeon, Professor Richard Field, explains more about how an anterior hip replacement procedure is performed. 

The procedure

In an anterior hip replacement, the surgeon makes a small incision at the front of the hip. Using specialised instruments, the surgeon then navigates between the muscles and tissues, allowing access to the hip joint without cutting through major muscles.

 

The damaged hip joint is then removed and replaced with a prosthetic implant. This technique is considered muscle-sparing, which is believed to contribute to a faster recovery and lower risk of dislocation.

 

Benefits and considerations

One of the primary benefits of anterior hip replacement is a quicker recovery time. Patients often experience less pain after surgery because the muscles are not cut or detached. Additionally, because the anterior approach involves less disruption to the muscles and tissues, there may be fewer restrictions on movement after surgery, allowing patients to return to normal activities sooner.

 

Another advantage is a lower risk of dislocation, a common complication in hip replacement surgeries. However, the anterior approach is technically challenging and requires specialised training and equipment. Not all surgeons are experienced in this method, and it may not be suitable for all patients, especially those with certain anatomical variations or severe deformities.

 

Recovery and rehabilitation

Recovery from anterior hip replacement typically involves a shorter hospital stay, often ranging from one to three days. Physical therapy usually begins immediately after surgery to help patients regain strength and mobility.

 

Most patients can walk with minimal assistance within a few days and may return to normal activities, such as driving, within two to four weeks. Full recovery generally takes about three to six months, depending on the individual’s overall health and adherence to rehabilitation protocols. 

By Professor Richard Field
Orthopaedic surgery

Professor Richard E. Field is a world-renowned hip and knee surgeon with practices in both the NHS and Private sectors. He is the Professor of Orthopaedic Surgery at St George’s University of London.  He was appointed on the staff of St Helier Hospital, Surrey in 1994 where his NHS practice was based until the South West London Elective Orthopaedic Centre (SWLEOC) opened in 2004. He has been SWLEOC's Director of Research since the centre opened and leads the centre's academic surgical team. His private practices are based at the Lister Hospital in Chelsea and St Anthony’s Hospital in Cheam.

Professor Richard Field qualified from the Westminster Hospital in 1980.  His PhD was undertaken at Cambridge University, on the design of a hip resurfacing implant. He has been actively involved in the design and evaluation of new hip and knee designs throughout his career. Professor Field has undertaken many world-first operations. His pioneering work in arthroscopic hip surgery was recognised by his Presidency of ISHA, the International Society for Hip Preservation Surgery in 2016-17.

Professor Field has been undertaking hip resurfacing since 1995 and adopted the muscle sparing, Direct Anterior Approach (DAA) for hip replacement in 2008. He is the UK's most experienced surgeon in DAA hip replacement.  

Professor Field has built up one of the world’s largest and most comprehensive databases on the outcome of hip and knee replacement and has published extensively on hip preservation and joint replacement surgery. He was an advisor on Hip replacement to the National Institute of Clinical Excellence (NICE), a board member of the British Hip Society and President of ISHA, the International Society for Hip Preservation Surgery. He continues to teach and lecture, in the UK and abroad, on hip and knee surgery.

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