Anterior Hip Replacement

Minimally Invasive Hip Arthroplasty

Minimally invasive techniques for hip arthroplasty have become increasingly popular, offering potential benefits in terms of reduced muscle dissection, smaller incisions, less blood loss, and faster recovery times.

The advantages of anterior hip replacement

  • Frontal entry for hip replacement enables muscle separation instead of splitting, reducing postoperative pain.
  • Anterior hip replacement, in appropriately selected patients, is associated with less pain, especially in the first two to four weeks, and offers better measurement of leg length and implant position.
  • Different postoperative precautions are required for each approach to prevent hip dislocation, with fewer precautions for anterior replacements.
  • Re-operation rates are similar for both approaches. However, the posterior approach may entail a higher risk of hip dislocation in certain cases. Deep infection rates are comparable for both approaches.

Other approaches to the hip are: the posterior approach, where the small muscles at the back of the hip are cut to access the hip and repaired back to bone; and the lateral approach (or anterolateral approach), where the gluteus medius muscle on the side of the hip is cut to access the hip and then stitched together afterwards.

Through his training and mentoring both locally and internationally, Dr Manjra has had the opportunity to have rigorous training in the various surgical approaches to the hip.

Dr Manjra favors the DAA and uses the approach routinely, capitalizing on the superior outcomes early after surgery. However Dr Manjra, still does make use of the posterior approach especially in complex or revision cases.

Dr Manjra does not use the lateral or (anterolateral) approach as it involves cutting the gluteus medius muscle on the side of the hip. Dr Manjra aims to maintain the gluteus medius muscle for its critical role in maintaining hip function and stability.

Who can have an anterior hip replacement?

The decision is made by the surgeon on a case- by-case basis, but certain patients are not well- suited for this procedure, and if they do undergo it, it may require longer incisions. This includes people who have:

  • Yimplants or metal hardware in the hip from prior surgery
  • very muscular or obese (BMI > 40) body type
  • a wide pelvis
Are anterior hip replacements successful?
It is important to note that the results of total hip arthroplasty are outstanding in terms of relief of pain and improvement in function. There has been, to date, no clinical study demonstrating the superiority of one surgical approach over another. The possible short- term benefits of one surgical approach over another must always be balanced with the possible untoward side effects unique to that approach.
What are the disadvantages of anterior hip replacement?

Disadvantages to the anterior approach are both practical and medical.

  • There is a risk of a numb, tingling or burning sensation along the thigh, referred to as lateral femoral-cutaneous nerve damage which is almost always temporary.
  • Superficial wound issues are slightly more common in the anterior approach when done on obese patients