By Dr. Walker Flannery, Orthopedic Surgeon

The hip joint is the biggest joint in the body. It can also cause some of the biggest problems and pain in the body. Your hips are the center of movement. They allow for your body’s wide range of motion but also support the weight of your body. Often times, when you have hip pain, you have pain elsewhere, simply because of the magnitude and importance of the hips’ job.

Hip replacement surgery is a common treatment for hip damage or severe hip pain. Basically, the femoral head (highest part of the thigh bone) is removed and replaced with an artificial one. This prosthetic femur head is shaped like a ball and fits perfectly into the rounded cup prosthesis that becomes the new socket of the pelvis.

Different surgeons take different approaches to removing the damaged hip and replacing it. With the anterior approach, the hip joint is accessed from the front of the hip. With the posterior approach, the joint is accessed from the backside of the hip. The same hip implants can be used regardless of the approach.

The How and What of the Anterior Approach to Hip Replacement

• Incision: With the anterior approach, the incision is made at the front of the hip. It starts just below the top of the pelvic bone and extends down toward the upper thigh. It is four inches in length.
• Muscles: The work happens between the muscles, with minimal or no muscle cutting. This is considered an “internervous” approach, whereas the muscles that carry nerves throughout the body are separated – a natural separation that allows ready access to the hip joint. The key buttock muscles are not injured, which allows for faster recovery and limits risk of “limp gait” or “foot drop.”
• Positioning: A specialized Hana Table can be used, allowing the patient to lie flat instead of on his or her side during surgery. This provides surgeons a faster way to check key criteria; leg lengths, implant position, and implant size via X-ray. The table can also change position during surgery to aid the surgeon’s visibility without cutting more tissue.
• Recovery: After surgery, patients can cross their legs, tie their shoes, and get into low seated cars, couches, or chairs with no worries. No “hip precautions” are given with surgery, and the risk of the hip “popping out” or dislocating after the procedure is lowest of all approaches.
• Candidates: Most patients are appropriate for anterior hip replacement. A body mass index (BMI), which calculates a patient’s height and weight, can be used as a guideline with a BMI of under 35 recommended. The decision on which approach would be best will be made as part of the surgery discussion during your office visit.

With the ability and expertise to perform both anterior and posterior hip replacement, OSMS is able to provide guidance and review risks and benefits of all your options. The best course of action will be decided together.

If you are feeling pain in your hip or groin, are limping, or experience loss of motion in your hip, please schedule an appointment for evaluation. We’ll get you back to the life you love.

Dr. Walker Flannery is an Orthopedic Surgeon with OSMS and sees patients in Green Bay and Marinette. Schedule an appointment with him here.