Understanding Anterior Hip Replacement: A Q&A with orthopedic surgeon Dr. Walker Flannery

We are proud to introduce orthopedic surgeon Dr. Walker Flannery! He’s a Wisconsin native who will be joining our physician team in September.

One of his areas of interest is anterior hip replacement. During his residency training, Dr. Flannery worked with four different orthopedic surgeons who performed anterior hip replacement. After seeing how well patients did with this approach, it became a special interest of his. We asked Dr. Flannery a couple of questions to help explain this approach to hip replacement.

Q: How is the anterior approach different than other hip replacement methods?

A: There are several approaches for hip replacement that have been used over the last half-century with good success. While the anterior approach is relatively new compared to other methods, it has been used for hip replacement with a strong track record for over 15 years. The anterior approach is increasing in popularity for several reasons:

  • It uses an “inter-nervous plan,”allowing a path between muscle groups to insert the implants, preventing injury to the buttock muscles. This can help aid in a quicker recovery, such as earlier walking without a cane and less pain medication use. There also can be a lower risk of “limp gait” or “foot drop” in comparison to other approaches.
  • Surgeons use a specialized Hana Table that allows the patients to remain in a flat position on their back, instead of on their side. This enables the surgeon to check key criteria – like leg lengths and implant positions – using a real time X-ray machine called fluoroscopy. The table can also change positions during surgery to aid in the surgeon’s visibility.
  • Due to the nature of the anterior approach, the risk of the hip “popping out” or dislocating after the procedure is lower. Patients are allowed to go about their activities after surgery without many of the hip precautions that are typically needed, such as not bending past 90 degrees at the the hip.

Q: Who is a candidate for anterior hip replacement?

A: Many patients who need a hip replacement are good candidates for the anterior method. However, just like with any surgery, it’s important for patients to understand the risks and benefits of each approach to hip replacement and for patients and their surgeons to discuss which approach will be the best option for their individual needs.

Characteristics that could make anterior hip replacement technically challenging include:

  • Women who are short statured with a wide pelvis bone.
  • Patients who are large statured and muscular, i.e. former football lineman.
  • Patients who carry most of their weight in the abdomen with a high body mass index.
  • If the surgery is a revision surgery that would involve replacing the implant inside the upper leg bone (the femoral component).

These criteria will not exclude you from the anterior approach to hip replacement. They will be considered in the decision making process with your surgeon following a physical examination of the hip.

“Anterior hip replacement is a technically challenging procedure and requires a specific skill set for the surgeon. It is currently offered by less than 25% of orthopedic surgeons,” says Dr. Flannery. “By being proficient in the other approaches to hip replacement, I can help provide guidance on which method would be the best fit for each individual I care for.”

Learn more about Dr. Walker Flannery here.

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