This type of hip replacement can expedite recovery

If you or someone you know is about to get hip replacement surgery, you may be expecting a long road ahead. However, a swift recovery has become commonplace due to surgical advancements.

Total hip replacement is one of the top orthopedic surgeries performed in the United States, second only to knee replacement. In fact, more than half a million hip replacements occur each year.

“Total hip replacement surgery is a game changer for quality of life because it restores mobility for people who are suffering in pain due to joint damage by injury or common degenerative disease, like arthritis,” says Dr. Andrew Rizzi, an orthopedic surgeon at Aurora Health Care. “The good news is the surgical procedure continues to improve.”

Surgical options

When hip replacement surgery is recommended, there are two common surgical approaches to consider:

• Posterior hip replacement: In this traditional approach, surgery is performed from the back of the hip, closer to the buttocks. This approach requires splitting muscles, like the gluteus maximus, to perform the replacement. However, the major anterior muscles and hip abductor muscles are left intact.
• Anterior hip replacement: Surgery is performed from the front of the hip and involves minimal muscle disruption by working between muscles rather than cutting through them. The posterior muscles are left intact.

Less common options are lateral surgery where the procedure is performed through the side of the hip or a combination of surgical approaches.

Pros and cons

One approach isn’t necessarily better than the other, however, data shows that many joint replacement surgeons are choosing to perform the anterior approach.

One reason for this is many patients find it easier to regain movement in the initial weeks after surgery because there is less muscle disruption compared to the posterior approach.

“The biggest advantage of the anterior hip replacement is that it’s considered a muscle sparing approach,” Dr. Rizzi explains. “Typically, it accelerates recovery, reduces the length of your hospital stay and gets you on the road to restored movement faster.”

Anterior hip replacement also results in a slightly lower rate of dislocation within the first three months, according to Dr. Rizzi. After three months, rates of dislocation for either procedure are the same.

Dr. Rizzi notes there are factors that disqualify a patient from the anterior option. For example, he does not recommend anterior surgery for patients with a BMI of 35 or higher.

“Surgery becomes more difficult when you have a higher BMI because you may have overhanging soft tissue that can irritate or compromise the wound healing process, which can create problems,” Dr. Rizzi explains. “Other disqualifiers are having implants or metal hardware in the hip from prior surgery or having a particularly wide pelvis.”

For any replacement, recovery takes at least one year, with 90% to 95% of the improvement occurring in the first three months after surgery. The rest comes over time.

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