The hip joint is powered by large muscles and is covered with a rubbery type of tissue that pads the joints. When all of the parts, cartilage, muscles and tendons are healthy, a hip should move easily.
A hip is diseased when one or more parts of the hip are damaged and movement becomes stiff. Over time, cartilage starts to crack or wear away. When this happens, the bones making up the joint rub together. Stiffness and pain occur when the ball starts to grind in the socket. Unfortunately, cartilage does not have the ability to repair or replace itself like other tissues in the body. Once cartilage is damaged or destroyed, it is gone forever.
The surgical procedure involves an incision through the skin to gain access to the hip joint through the muscles overlying the hip, all done while the patient is under anesthesia.
Watch Video on Total Hip Replacement
The hip socket (acetabulum) is prepared by using special instruments to make it the right size and shape for a new implant. The femoral head is replaced with an artificial ball on a stem that goes down into the hollow part of the thighbone and may be pressed into place or cemented, depending on the surgeon’s preference. A metallic shell with a cup-shaped liner is pressed into the prepared socket to provide a smooth gliding surface. The ball and socket are then placed together to complete the procedure.
Exactech’s total hip implants are designed to maximize range of motion through innovative designs that provide strength while preserving as much of a patient’s natural anatomy as possible.
Direct Anterior Approach
The direct anterior approach to hip replacement surgery allows the surgeon to access the diseased hip joint through the front of the hip. A major advantage of this approach is that it allows your surgeon to work through natural intervals between the muscles around your hip, without having to cut through the muscles or detach them from the pelvis or thighbone.
This preservation of your soft tissues may result in a faster return to weight-bearing activities, less pain and a quicker overall recovery time. Keeping these muscles intact may also help reduce the likelihood of dislocation, which may occur when muscles weakened in surgery are not strong enough initially to keep the new femoral head in the socket. The patient can also avoid the pain of sitting on the incision site since the anterior approach is performed through the front of the hip.
Why aren’t all hip replacements performed through the anterior approach?
Hip replacement can be performed through:
- the back of the hip (posterior approach)
- the side of the hip (lateral or anterolateral approach)
- the front of the hip (anterior approach)
- or through a combination of approaches.
Direct anterior approach hip surgery requires implants and surgical instruments that are compatible with the approach. Specialized surgical tables, although not necessary, may facilitate the anterior approach by allowing precise positioning of the patient during surgery.
Watch Video on Direct Anterior Approach
What preparation is required prior to surgery?
In order to minimize risks, your surgeon may have you see your family physician before surgery to obtain tests. You also may need to have any upcoming dental work completed or prepare your home to avoid any post-surgery falls.
How long will my joint replacement last?
There are implants that have been documented to last 15-20 years. However, there are numerous factors that affect the longevity of a total joint replacement including patient indications (age, weight and activity level), implant design and materials used during surgery.
Just like your natural joint, the components of an artificial implant are subject to wear over time from friction caused by bending, straightening and supporting your body weight.
What is recovery like after joint replacement?
Therapy may begin the same day as your surgery and may continue up to four to six months post-op. Exercise is crucial for proper rehabilitation to promote blood flow, strengthen muscles and regain motion. Proper rehabilitation and willingness to follow all of your surgeon’s recommendations will contribute to a more successful recovery after surgery.
What activities can be resumed after surgery?
Most patients are able to resume everyday activities like climbing stairs and possibly driving three to four weeks post-op depending on your surgeon and your condition. This includes waist-level activities like writing for shoulder replacement patients. Activities such as golf, doubles tennis and swimming can usually be resumed, but only after a thorough evaluation by your surgeon. Recovery time will vary for each patient.
High-impact activities or contact sports are typically not recommended. These types of activities place an extreme amount of pressure on the joints, which could lead to complications.
What are the risks associated with joint replacement surgery?
Joint replacement surgery is a major operation and although it is extremely successful in most cases, some patients may experience complications, including but not limited to: infection, blood clots, implant breakage, malalignment and premature wear. Any of these can require additional surgery.