Is one really preferred? … In other words, in cases of patients who've had bilateral hip replacements (whether staggered by weeks or years, or done at the same time), notable feedback is that they preferred the anterior replacement. So, which hip replacement approach should you request from your orthopedic surgeon? Patients who are active, in good physical shape and younger are often the best candidates for an anterior approach hip replacement. A variation of this approach is a minimally invasive procedure in which one or two shorter incisions are used. He adds to this by saying, "however, there's one caveat: patients should seek out a surgeon who is well-trained and experienced with the anterior hip surgery. We asked Dr. Salyapongse whether or not an anterior approach is worth switching surgeons for. AARP members receive exclusive member benefits & affect social change. In other words, in cases of patients who've had bilateral hip replacements (whether staggered by weeks or years, or done at the same time), notable feedback is that they preferred the anterior replacement. The liner is most commonly made of a medical grade plastic called polyethylene. Some of the commonly cited downsides to the anterior approach is that it is less common and hasn't been done for as long as the posterior. Minimally invasive hip replacement are another option for hip replacement procedures. The procedure is intended to give you restored mobility and to reduce painful bone-on-bone contact. You will be asked to register or log in. For example, some surgeons believe that the best candidates for anterior hip replacement surgery are patients who are not obese or overly muscular. There's more to a hip replacement surgery than meets the eye. Hip | Total Joint Replacement. Get matched to a top surgeon near you or book a free consultation with Dr. Salyapongse. Once you confirm that subscription, you will regularly The hip joint is where the head of the thigh bone or femur meets the pelvis. The incision used in this posterolateral approach, as it is called, is about six to nine inches long and is made along the side of the hip and the upper thigh. But now, orthopedic surgeons are employing a new, easier alternative called subchondroplasty, in which a damaged hip is strengthened by injecting a cement-like material. Another con that Dr. Salyapongse points out is  "the occasional sense of numbness over the side of the thigh after surgery." The hip replacement operation has become a routine procedure. In other words, Dr. Salyapongse believes that the anterior approach is superior to posterior (hehe, we rhymed!). Dr. Salyapongse explains what he has seen first hand: "patients who have had anterior hip surgery on one side and posterior hip surgery on the other, most often prefer the anterior hip side." A hip replacement is also known as hip arthroplasty or a total hip replacement. Both are procedures used to replace the worn ends of the bones in the hip joint. Members save 15% on medical alert service. Surgeons should stop carrying out a common type of hip replacement operation on women because of … If you think that you might be a good candidate for a robotic-assisted total hip replacement, you should talk to your doctor. The other is the lateral approach. This artificial joint (prosthesis) helps reduce pain and improve function. Which approach is better? Osteoarthritis is painful as joints become stiff and inflamed when the smooth lining between the joints gets damaged or wears away. Hip replacement (total hip arthroplasty) is surgery to replace a worn-out or damaged hip joint. But as time goes on, anterior and posterior hip replacement patients both do very well.". So, what can you make of all of this? Advocates say it’s easier, less invasive, and has a … The difference with the anterior hip replacement procedure from the traditional method is the technique used to reach the hip joint. The decision to undergo a total hip replacement involves a number of considerations, including choosing the surgical approach that is best for you. The physicians at the Cedars-Sinai Orthopaedics are consistently striving to develop new technologies, instrumentation and techniques for hip replacement surgery. Vasileff says he has used the procedure to repair the hips of patients from their 20s to 50s, but he thinks it also would work on older patients as long as they don’t already have a lot of arthritis. Dr. Salyapongse adds, "recent studies have shown that early recovery (the first 6-8 weeks) after anterior approach surgery seem to be faster and less painful.". Read on, mate. He elaborates, "the anterior approach involves a true internervous/ intermuscular plane. You must be logged in to leave a comment. | A longer procedure time means greater potential for increased blood loss (although this is low risk). It … Hip replacement surgery has come a long way in the past couple of decades, with faster recovery times and lower risk of complications. Salyapongse explains what he has seen first hand: "patients who have had anterior hip surgery on one side and posterior hip surgery on the other, most often prefer the anterior hip side." More than 300,000 patients in the U.S. have hip-replacement surgery each year, which can require grueling rehabilitation and months of recovery before they can get back to normal. Is one approach really better than the other? The implant procedure is the same, but the surgery may take longer because physicians work with x-rays and special instruments to guide them through the small … I would say I had minimal pain, they gave me plenty of pain medication, only took about 10 pills and was totally off them by three weeks. While there are many ways to access the hip joint to perform a total hip replacement, this method is one of the safest and most efficient ways to preserve and protect all the important structures around the hip joint and to facilitate both early recovery and long-term function. Anterior or posterior? The reason being, Dr. Salyapongse shares it that "they report faster recovery, easier rehabilitation, and less pain". AARP is a nonprofit, nonpartisan organization that empowers people to choose how they live as they age. Please enable Javascript in your browser and try Asking orthopedic surgeons what hip replacement is best is like going to a car show and asking people which car is best. “The hip replacement is one of the most successful surgical procedures in terms of quality-of-life improvement,” he explains. A return to full activity, including playing sports, can take six to nine months, he said. In hip replacement surgery, the damaged bone surfaces and cartilage are removed and replaced with implants. Patients should consult with a physician to discuss the various types of hip replacement procedures if pain and stiffness start to interfere with life. W. Kelton Vasileff, an orthopedic surgeon at the Ohio State University Wexner Medical Center, says the procedure originally was developed to treat ailing knees. Hip replacement (total hip arthroplasty) is surgery to replace a worn-out or damaged hip joint. Then they inject the cement-like material, which solidifies within minutes. Hip pain caused by this damage can be treated in several ways. Javascript must be enabled to use this site. This post is part of the Ultimate Guide to Total Hip Replacement. The Anterior hip approach has a higher complication rate in inexperienced users and there is no data showing better long term outcomes. In short, both approaches result in a hip replacement. U.S. News also ranks the best hospitals for hip replacement surgery using data on patient survival, nurse staffing, volume and more. Both surgeons point out that the most important determining factor actually lies in your choice surgeon. In the meantime, please feel free As a result of not cutting muscles, less of the patient's natural anatomy is tampered with. Anterior hip replacement accounts for only 15 to 20 percent of THR surgeries in the U.S. Anterior hip surgeries are relatively new, and although they provide excellent outcomes, most surgeons still use the traditional posterior method. The incision used in this posterolateral approach, as it is called, is about six to nine inches long and is made along the side of the hip and the upper thigh. If you're preparing for a hip replacement surgery, you've probably asked yourself these very questions. A hip replacement is a common type of surgery where a damaged hip joint is replaced with an artificial one (known as an implant). How to Determine Which Hip Replacement Surgery Method is Best for You. More than 300,000 patients in the U.S. have hip-replacement surgery each year, which can require grueling rehabilitation and months of recovery before they can get back to normal. In saying this, like most things in life, the more you know, the better you can do. The Lancet. Nowadays, another common technique known as a minimally invasive method is used by surgeons, in which 1 or 2 cuts are given, 2 to 5 inches long. The three main approaches - posterior, anterior and lateral all have their benefits and problems. Learn about the different types of hip replacement implants and materials. Traditionally, orthopedic surgeons have approached the hip joint from the side and back when doing total replacement surgery. According to Vasileff, recovering from a subchondroplasty is far less arduous than a total hip replacement, in which surgeons completely remove the damaged femoral head and the cartilage surface of the socket and replace them with artificial parts. Other reasons for hip replacement include injury, infection, and brittle bones. Robotic-assisted hip replacement can be used in patients who suffer from degenerative hip diseases such as arthritis or hip conditions caused by injury. Robotic-assisted hip replacement can be used in patients who suffer from degenerative hip diseases such as arthritis or hip conditions caused by injury. Hip replacement surgery usually takes 2 to 3 hours. Surgeons who typically perform at least 100 hip replacement procedures per year are in the best position to adopt shorter incisions, while keeping the procedure the same. An orthopedic surgeon can do these procedures from behind the hip, to the side of the hip, or from in front of the hip. Hi, I'm Grace. The anterior approach can also take longer to perform as it is slightly more complicated. Metal-on-metal hip resurfacing is done in a similar way, however this is rarely done now because of possible complications and a higher "failure rate". To replicate the action of your natural joint, a total hip replacement has 4 parts: a socket (cup), liner, ball (head) and stem. Hip replacement surgery is a procedure in which a doctor surgically removes a painful hip joint with arthritis and replaces it with an artificial joint often made from metal and plastic components. A. Greater potential for post-op numbness in the upper thigh. The new procedure injects a cement-like material into the damaged hip which solidifies within minutes. Ultimately, the hip replacement implant you end up with is selected by your surgeon depending on fit, your arthritic damage, activity level, weight, age, and other lifestyle factors. It usually is done when all other treatment options have failed to provide adequate pain relief. “But when there is a complication, it’s not pleasant. The socket is replaced with a durable plastic cup, which may or may not also include a titanium metal shell. The hip joint is exposed and the damaged part is removed and replaced with the prosthesis. We explain the difference between hip replacement options: a traditional posterior surgery and the … to search for ways to make a difference in your community at An X-ray of the pelvic area, showing a metal replacement hip. However, the difference between the approach is where the incision is made to access the hip. In saying this, Dr. Salyapongse adds that "if you have the means and time to seek out an experienced anterior hip surgeon (e.g. He also notes that the anterior approach may not be the best option for someone who is obese or has muscular thighs, because extra soft tissue can make it harder for the surgeon to reach the hip joint. Knowing about the different manufacturers, styles and materials will help you work with your surgeon to select the best implant for you beforehand. Read on as we try to help you answer this tough question. The anterior approach hip replacement is a muscle-splitting approach, meaning that the surgeon gets to the hip between two muscles, rather than by removing and then reattaching a muscle. Here's what he had to say:  "If you have a good relationship with your surgeon, I would trust them to perform the procedure for you with which they have the most experience (anterior OR posterior)." In a posterior approach, the incision is made through the back of the hip while you're on your side. WW will help you build a customized weight loss plan. Best Hospitals for Hip Replacement Hip replacement surgery is usually recommended when a person has extreme inflammation and arthritis in the hip joint, making it painful to do daily activities. During hip replacement, a surgeon removes the damaged sections of your hip joint and replaces them with parts usually constructed of metal, ceramic and very hard plastic. by Patrick Kiger, AARP, January 18, 2018 U.S. News also ranks the best hospitals for hip replacement surgery using data on patient survival, nurse staffing, volume and more. Less invasive, leaving more muscles and tissues in tact, Closer to a "normal gait" in the first six weeks after surgery. The patient is typically lying on his or her side, and the hip is approached on the side and then around the front (anterior) portion of the hip. Total hip replacement (also known as hip arthroplasty) is a common orthopaedic procedure and, as the population ages, it is expected to become even more common. However, this is not the case with hip replacement. The most common type of hip replacement surgery is called a total hip replacement (also called total hip arthroplasty). The surgeon replaces the old joint with an artificial joint (prosthesis). Traditionally, orthopedic surgeons have approached the hip joint from the side and back when doing total replacement surgery. This approach is considered the "traditional", "tried and true" method. Of these, osteoarthritis accounts for the majority of patients needing a hip replacement operation. You'll start receiving the latest news, benefits, events, and programs related to AARP's mission to empower people to choose how they live as they age. The decision to undergo a total hip replacement involves a number of considerations, including choosing the surgical approach that is best for you. You are leaving AARP.org and going to the website of our trusted provider. When it comes to your health, you should always be careful what you read online. Anterolateral (Watson-Jones). The advantage of resurfacing is the minimal removal of material saving most of the femur. The advantage is thought to be that rehabilitation can proceed more quickly by not having to allow the reattached muscle to heal. In an anterior approach, the replacement is done through the front while you lay on your back. This artificial joint (prosthesis) helps reduce pain and improve function.Also called total hip arthroplasty, hip replacement surgery may be an option for you if your hip pain interferes with daily activities and more-conservative treatments haven't helped or are no longer ef… Should I have an anterior or posterior hip replacement surgery? A systematic review and meta-analysis of case series and national registry reports with more than 15 years of follow-up. I just recently, three months ago had a total hip replacement by the anterior method, My surgery was at 7:30 and I was home by lunchtime, I walked out of the “hospital” actually outpatient facility with my walker. Mayo Clinic in Rochester, Minn., and Mayo Clinic in Phoenix/Scottsdale, Ariz., are ranked among the Best Hospitals for orthopedics by U.S. News & World Report. ER trips often point to larger health problems for older patients, Keep Sharp: Build a Better Brain at Any Age Book. The size and placement of the incisions will be different. Only 3% of hip replacement surgeries in the US are hip resurfacing. Traditional hip replacement During a traditional hip replacement, an incision is made on the side of the hip. We love telling people about what we're doing! There is no 'best' method for performing a hip replacement. Let's sum it up: anterior approach shows some serious pros when it comes to a faster "return to normal" in early recovery. To get to the bottom of the "anterior vs. posterior" debate, we spoke with top orthopedic surgeon, Dr. Aaron K. Salyapongse. You can also manage your communication preferences by updating your account at anytime. This can mean faster healing. they've performed more than 1000 procedures) then I would consider doing so. In many cases, well-trained surgeons using special instruments can shorten the incision of a standard hip replacement to about 4 inches. Especially when it comes to a surgery like hip replacement. Read on for this and other useful info like how to prehab for hip and knee replacements. But now, orthopedic surgeons are employing a new, easier alternative called subchondroplasty, in which a damaged hip is strengthened by injecting a cement-like material. A. This means that some surgeons are not as well-versed in the anterior approach. In contrast, the patient criteria for anterior hip replacement may be more stringent. This allows precise placement of components that are correctly sized. again. Read on as we explain what the anterior approach is, how it differs from posterior, and share the pros and cons of an anterior hip replacement. Looking to have a hip or knee replacement surgery? According to the American Association of Orthopaedic Surgeons, more than 200,000 hip replacements are performed each year. Anterior hip replacement is done with the patient lying on their back on a special table that allows precise positioning of the affected leg. This surgery may be a choice after a hip fracture or for severe pain because of arthritis. What is hip replacement? Without a doubt this can make for an easier "return to normal"  and underscores a possible jumpstart on recovery. In the next 24 hours, you will receive an email to confirm your subscription to receive emails It replaces your hip joint with an artificial one. The most important factor to consider is that your surgeon should be well trained and comfortable with whichever approach they will utilise. 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