Direct Anterior Hip Replacement

Q & A with Dr. Jeffrey T. Hodrick, MD regarding Direct Anterior Hip Replacement Surgery. Dr. Hodrick is a Board Certified, fellowship-trained Orthopaedic Surgeon the Southern Joint Replacement Institute in Nashville, TN.

What is the Direct Anterior Approach? Although not new, the direct anterior approach is a modern technique used to perform a hip replacement. Direct anterior patients can have less pain and inflammation following the procedure. Many patients, if medically qualified, are able to return home on the day of surgery.

How is the Direct Anterior Approach different than the traditional Posterior Approach? Traditionally hip replacement was done through the posterior approach. During this surgery, the patient is laying on their side. The incision is carried through the gluteus maximus, cutting through the largest muscle in the body. In order to access the hip joint, several tendons are detached and then later reattached at the completion of the surgery. During the direct anterior approach, muscles are spread apart rather than cut, and no tendons are released. The patient is laying on the back during the surgery, allowing a portable x-ray machine to be used during the surgery. This x-ray machine helps to make sure the replacement parts are in the correct orientation and the legs are the same length.

Do you have any precautions or rules to follow after Direct Anterior Approach Hip Replacement? Because the tendons and capsule in the back of the hip are not released or incised during direct anterior hip replacement, I do not give the patients any hip precautions or rules to follow after surgery. 

Is everyone a candidate for Direct Anterior Hip Replacement? Almost everyone with painful hip arthritis or avascular necrosis is a candidate unless they have had previous surgical hardware or implants placed in the back of their hip. Your surgeon will explain why you are or aren't a candidate for direct anterior hip replacement.

How long is the typical hospital stay after Direct Anterior Hip Replacement? Patients typically walk about 3-4 hours following surgery once their anesthetic has worn off. If the patient is medically qualified, has appropriate social support, and is motivated, they may be a candidate for same-day outpatient direct anterior hip replacement. If patients do not qualify, they typically spend one night in the hospital and discharge the following morning. 

What is the expected recovery time after Direct Anterior Hip Replacement? Although recovery times vary patient by patient, most are feeling good by 3-4 weeks following surgery. Full recovery can be expected by 3 months while the patient will continue to gain strength and stamina up until one year after the procedure. 

What is the most common thing you hear from patients following Direct Anterior Hip Replacement? The most common thing we hear from patients following direct anterior hip replacement is that they "wished they had done it sooner!" Although hard to believe, many patients wake up with less pain than before the surgery!

To learn more about hip replacement and other services provided by Dr. Hodrick, please visit www.nashvillehipandknee.com

Author

Jeffrey T Hodrick, MD Dr. Hodrick is a board certified, fellowship trained, Orthopaedic Surgeon who practices at the Southern Joint Replacement Institute in Nashville TN. Dr. Hodrick is an international expert on robotic assisted joint replacement, direct anterior hip replacement, and enhanced recovery following joint replacement. His approach to patient care is to treat every patient as if they were a member of his own family.