Know Your Options: Direct Anterior Approach to Total Hip Replacement

The Centers for Disease Control and Prevention reports that each year in the United States, more than 330,000 people have surgery to replace diseased, injured or worn-out hips with new artificial parts. If you are one of these people, ask your orthopedic surgeon if you are a candidate for the anterior-lateral approach (anterior means front) for total hip replacement. This surgical technique offers potential benefits over the standard posterior or lateral approach taken by most surgeons.

Approaching the hip through an incision in the front of the body allows the surgeon to avoid cutting muscle tissues surrounding the hip. By sparing these muscle tissues, a surgeon is able to reduce the patient’s pain and improve their overall mobility immediately following a procedure. As a result, a patient recovers much more quickly and is able to avoid weeks or months of prolonged physical therapy.

St. Joseph Mercy Oakland Orthopedic Surgeon Andrew Ciarlone,DO, who has performed more than 500 anterior-lateral total hip replacements since 2011, refers to the approach as the “rapid-recovery hip replacement.” Dr. Ciarlone says: “When the incision point is made from the back, a surgeon must cut through muscle tissues to reach the hip. By choosing to make an incision from the front, a surgeon can work between the muscles to stabilize the joints and place the artificial components.”

According to Dr. Ciarlone, his average patient is back on their feet in just a few days, requires less time in formal therapy and returns to work within weeks. “Some patients have gone home the very same day as surgery,” he says. “Though these patients are outliers, their results speak to how quickly people can recover following hip surgery using the anterior approach.”

Dr. Ciarlone is quick to emphasize that this is not a new technique. In fact, it has been around for decades. More recently, however, it has re-emerged as a more viable option due to the availability of more advanced instruments that allow for smaller, less invasive incisions.

Whether to have your hip replaced is a decision best made after talking with your family and your primary care doctor.

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