The anterior approach to hip arthroscopy (replacement) is an innovative alternative to traditional hip replacement in which the incision to access the joint is made on the front of the leg rather than the back or side of the leg. By using this approach, our surgeons are able to access your hip joint by gently spreading the muscles, leaving them relatively undisturbed whereas. In a traditional joint replacement, these muscles would be cut in order to access the joint. Leaving the muscles intact allows for faster healing, helps reduce the risk of dislocation, and post-operative restrictions are not necessary.
The anterior approach is possible through the use of the HANA® Table, a state of the art fracture table with padded leg supports that can be adjusted with a great deal of precision to help achieve excellent alignment and positioning of the hip implant.
How the HANA® Table works
Following anesthesia, the patient is laid flat on the Hana® orthopedic table. The carbon fiber struts that support the legs will move appropriately and manipulate the operated leg during surgery. The unique capabilities of the table facilitate the operation through this smaller and less invasive surgical approach.
The procedure itself begins with the surgeon exposing the hip in a way that does not detach muscles or tendons from the bone – a key attribute of the anterior approach. The surgeon removes the diseased cup portion of the hip and replaces it with an implant. The surgeon then uses the specially designed table to rotate the operative leg so the foot points outward, extending toward the floor. This allows excellent access to the thigh bone, or femur, so the surgeon can replace the diseased portion of the bone with the stem implant. This is important since visibility is often limited due to smaller incisions.
Side-by-side television screens are used to provide X-ray views of the operative hip and the patient's opposite hip. This comparison gives the surgeon the information used to determine the best positioning for an effective, stable hip replacement implant. The combination of this X-ray imaging and the high-tech table allows the doctor to seek more precise control over the patient's leg length as well. The incision length, which is typically smaller than with standard surgery, varies according to a patient's size, weight and other factors. The anterior approach lends itself to a relatively small incision because the hip joint is closest to the skin at the front of the hip. The muscle and fat layers are thinner than the muscle and fat tissue encountered when using other approaches on the side or rear of the thigh. The actual size of the incision for each patient varies.
Patients typically will not have any dislocation precautions to follow after surgery. Your surgeon will let you know if there are any. The anterior approach spares the major muscles of the thigh which allows patients to get back to activities of daily living with fewer limitations.