Muscle-sparing surgery from the front can mean more mobility sooner.
Fewer patients are putting off hip replacement surgery now that there are ways to reduce the time it takes to recover. “Many patients have lifestyles that favor a shorter recovery,” says John Scanelli, MD, a joint replacement specialist with the George Washington University Hospital.
Dr. Scanelli, who is fellowship trained in hip and knee replacement surgery, explains that patients themselves are seeking out this procedure. “The anterior approach, multimodal anesthesia and rapid rehabilitation protocols can decrease the time patients need to recover in the hospital after hip replacement. More patients are also going home rather than to long-term care facilities after hip replacement,” says Dr. Scanelli. “Some patients even safely go home the day of the operation.”
The anterior approach involves making the operational incision in the front of the hip rather than the side or back. What gives this technique its advantage is the fact that no muscles or tendons are cut during the operation. This usually makes it less painful and less difficult to recover. In most cases, patients are up and walking the day of surgery, and leave the hospital the following day.
“The posterior approach, or entering from the back, carries an increased risk of dislocation; and the direct lateral approach, entering from the side, is associated with an increased risk of a permanent limp,” says Dr. Scanelli. “The anterior technique has neither of these downsides.” He says because the patient is lying on his or her back during an anterior operation, instead of on their side, the surgeon can more accurately assess leg lengths.
Patients today want to return to an active lifestyle and get back to work sooner, and the anterior procedure can be one part of facilitating their rapid recovery. Modern hip replacement can now afford patients less pain and the ability to regain their mobility faster, with some discontinuing their walking aids within days to weeks after the operation. “Because we no longer have to cut through muscle to expose the hip joint, this approach is truly minimally invasive,” says Dr. Scanelli.
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