What are the Three Approaches for Total Hip Replacement Surgery?

What are the Three Approaches for Total Hip Replacement Surgery?
Dr. Dan Albright, orthopedic surgeon discusses the three approaches to hip replacement surgery: anterior, lateral and posterior and which approach he feels has the quickest recovery. For more information on hip replacement surgery and the different approaches, contact Dr. Dan …

Dr. Dan Albright, orthopedic surgeon discusses the three approaches to hip replacement surgery: anterior, lateral and posterior and which approach he feels has the quickest recovery.

For more information on hip replacement surgery and the different approaches, contact Dr. Dan Albright at 919-863-6808.

Summary of video:

There are three approaches to hip surgery. The approach means where the surgeon will make the incision to do the surgery. A surgeon focuses on anatomy. Anatomy is crucial to what a surgeon does during hip surgery.

The anterior approach is from the front of the hip (which is Dr. Albright’s preferred way).

The lateral approach is from the side of the hip. This approach s done with tougher surgeries or revision surgery. If someone’s had three, four, five surgeries, cancer or just some unusual situation, the surgeon will use this approach.

And then there’s the posterior approach and that’s what most of the country does. Our whole culture opens the gluteus maximus (your buttock muscle) and that muscle is split with the posterior approach.

The controversy amongst surgeons is we all think that the way we do it is the best. I’ve done all three approaches, in my hands, the anterior approach is what I believe works the best.

In the posterior and lateral approaches the surgeon splits muscle and you can’t stitch muscle back to the bone. Because no muscle is split with the anterior approach the hip joint is more stable and there are less dislocations. There’s some debate on that topic, but there are no restrictions after hip replacement surgery using the anterior approach. That’s a real big deal with a hip replacement operation. You can tie your shoes the first day, if you want. With posterior approach there are some real restrictions for some surgeons and that’s held true over decades.

With the anterior approach there is less muscle damage and that is a big deal, in my opinion. I don’t reattach anything. I just close the skin and the fascia, which is the covering over the muscle. It’s a very quick procedure going from the front and a quicker recovery.

Patients are out of bed within a couple hours after surgery and then home by the next day, most times. That’s pretty good, especially compared to the old days. Years ago when I trained, people were in the hospital for a week to ten days – in traction. The evolution of hip replacement surgery has been very good. I encourage you to Google “anterior hip replacements.” There is a lot of good information out there. I trained at Yale years ago and we were a center for anterior hips. I did a fellowship at Harvard in hip surgery, so I really like to focus on it because people are happy after they get this operation. They have a better life, a healthier life.