If you’ve been suffering with hip pain that affects your daily life, it may be time to consider getting a hip replacement. Before going through with this process, it’s important to consider several factors and do your research.

If you’re planning to get a hip replacement, one consideration is which surgical approach is best for you – anterior or posterior?

What’s the difference?

Hip replacement surgery can either be performed from the front of the hip (anterior) or from the rear (posterior). However, there is some debate on which is the best choice. According to an article published in the National Library of Medicine, “The posterior is the most traditional and popular approach worldwide, however the anterior approach has gained prominence during the second half of the 20th century due to favoring of its clinical outcomes and economic factors.” To determine which option is best for you, you’ll need to understand what each procedure entails.

An anterior hip replacement involves the surgeon making a four-to-five-inch incision through the front of the leg and working in between muscles. This method typically preserves more muscle function, and often does not involve the need to detach muscles from the bone.

A posterior hip replacement is the more commonly performed surgical approach in the U.S. and involves the surgeon entering from the back of the hip and cutting through muscle with a four-to-five-inch incision. This allows for better access and exposure to the joint.

Are you the right candidate?

Candidates who seek hip replacements are suffering from painful or damaged sections of the joint. Some conditions that can damage the hip joint include osteoarthritis, rheumatoid arthritis, and osteonecrosis. While most patients are candidates for posterior surgery, a candidate for anterior surgery requires patients not be overweight, have implants, or a wide pelvis. Typical candidates for anterior surgery are younger, in good shape, and frequently active.

Weighing your options

While a hip replacement is a minimally invasive surgery, it still requires research and consideration. Talk with your orthopedic surgeon to determine if anterior or posterior surgery is the right option for you.

Orthopedic surgeon Michael Fracchia, MD, says, “Hip replacement continues to be the number one elective surgery that patients are glad that they had done.  The risks continue to be low, with a significant improvement in a patient’s quality of life.  The primary advantage to an anterior hip replacement is a lower chance of dislocation, but the data one year after surgery shows the results are equal.  It is a great operation, for the right patient.”

Anterior advantages include:

  • Less chance of dislocation
  • Quicker procedure
  • Less painful recovery
  • Does not involve cutting into muscle

Anterior disadvantages include:

  • Weaker exposure to the hip joint
  • More challenging surgery
  • Not everyone is a candidate
  • Increased risk of infection
  • Potential injury to the Lateral Femoral Cutaneous Nerve

Posterior advantages:

  • Better exposure to hip joint
  • Fewer qualifications for a candidate
  • Good for heavier or muscular patients
  • Rarely creates nerve injury

Posterior disadvantages include:

  • Involves cutting through muscle
  • Slower recovery

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