The hip joint can develop a number of painful manifestations, whether due to fractures, injuries, or degenerative disorders, such as arthritis. Though pain medications and other treatment methods can grant temporary relief, they cannot lead to a pain-free life. A hip replacement is generally considered when a hip injury or disorder aggravates to a point where it is either restricting mobility or causing debilitating pain, even when resting. Most people who require hip replacement are in the age group of 60 to 80 years, owing to age-related wear and tear of the hip joint. There are two main approaches to hip-replacement surgery – posterior and anterior hip replacement. One notable difference between posterior vs anterior hip replacement surgery is how the surgeon accesses the hip joint. Continuing the discussion, the blog post provides a comparative analysis of anterior vs posterior hip replacement, with special emphasis on the pros and cons of each procedure. Take a look.
Posterior Hip Replacement
Posterior hip replacement is the traditional approach to hip replacement, wherein a surgeon makes a 10 to 12 inches long incision just behind the hip, working through the buttock muscles to reach the hip joint. The process is invasive and, after reaching the hip joint, the surgeon cuts the muscles and soft tissue that stabilize the hip to dislocate it. This is followed by the removal of arthritic surfaces and attaching prosthetic pieces as replacements. After that, previously cut muscles and soft tissue are reattached to relocate the hip, and finally, the incisions are closed.
Posterior hip replacement is an old and frequently used approach to hip surgery and provides the best view of the hip joint, eliminating potential complications during the procedure.
Low Risk of Fracture and Nerve Damage
Due to improved accessibility to the hip joint, there is an extremely low risk of fracture and nerve damage.
High Risk of Hip Dislocation
As the procedure involves cutting and reattaching the stabilizing elements of the hip, including muscles and soft tissue, the surgeon needs to take additional precautions to negate the probability of hip dislocation.
The process is invasive, as compared to the anterior approach, which reflects in slow healing times and slower achievement of rehab milestones.
Anterior Hip Replacement
Anterior hip replacement is an emerging surgical technique that is less invasive than the traditional or posterior approach. During anterior hip replacement, the surgeon makes an incision at the front of the hip, starting at the top of the pelvic bone and extending to the top of the thigh. The surgery involves working between the muscles to replace worn out surfaces with prosthetic components, without the need to detach and reattach them from the bones, a prerequisite for posterior hip replacement.
Less Pain After Surgery
The anterior approach doesn’t involve cutting or working through major muscles, therefore, patients can expect to experience less pain after surgery and feel more comfortable throughout the recovery period.
Low Risk of Damage to Major Muscles
Anterior hip replacement involves incisions at the front end of the hip, which features only a few muscles. Moreover, the technique is a direct opposite of the posterior approach, wherein major muscles are cut and reattached, posing a high risk of muscle damage.
Faster Recovery Times
As anterior hip replacement causes minimal muscle damage, patients can expect to get back on their feet within a few weeks, with the help of crutches or other supportive aids.
Minimum Risk of Hip Dislocation
In anterior hip replacement, muscles and soft tissue stabilizing the hip and preventing dislocation are left undisturbed. As a result, the probability of hip dislocation is almost zero.
Unsuitable for Super Obese Patients
Anterior hip replacement is often not recommended for obese patients, as the additional soft tissue poses a challenge to accessing the hip joint and performing the replacement.
In the anterior approach to hip replacement, the surgeon only has a limited view of the hip joint, making working between the muscles without causing a damage to surrounding structures and nerves a challenge.
Risk of Lateral Femoral Nerve Damage
The pathway of this nerve is close to anterior approach surgical incisions. As such, this nerve is at risk for injury due to tissue retraction.
The Bottom Line
Hip replacement surgery is often the last resort when conventional medications, steroid injections, and physiotherapy are ineffective in easing pain and discomfort. Before going for any surgical approach, our surgeons consider multiple factors, such as age and body weight of the patient, to assess the suitability of the method. Both anterior and posterior hip replacement have unique advantages and only a surgeon can decide the most suitable method for you. For that to happen, you need to go for medical consultation first if your hip pain is beyond bearable limits or an underlying disorder is now restricting your mobility. If you or someone you know is struggling with hip pain, doctors at Texas Health Spine and Orthopedic Center can help. Our team of surgeons possess extensive experience in both posterior and anterior hip replacement. To learn more about hip pain treatment options, book an appointment today. You can also call us at 1-888-608-4762.