What is Total Hip Replacement?
Total hip replacement surgery is traditionally performed from the posterior (back) or lateral (side) of the patient’s unhealthy hip. Both methods have their own advantages and disadvantages. However, in these methods, some muscles must be cut to access the hip joint, which can lead to complications during surgery due to nerves near the incision site. The muscles that are routinely cut during surgery can cause strength loss during early rehabilitation and bleeding in the early postoperative period.
Anterior hip replacement is a surgery performed by entering from the anterior (front) of the hip. During this surgery, a 10 cm incision is made in the patient’s skin, and the hip joint is accessed directly between the muscle planes without cutting any muscles. The prosthesis is placed in the hip joint using special tools. As a result, patients can return to their daily lives much more quickly.
Another advantage of anterior hip replacement is that positioning the patient and equalizing leg length is easier. In posterior and lateral hip replacements, the patient is usually positioned on their side with the other healthy leg underneath. This method can sometimes result in small errors when adjusting leg length.
In anterior hip replacement, the patient is placed on their back, allowing both legs to be fully positioned in the surgical field. This ensures the correct leg length during surgery, leading to a more natural walk and preventing slight limping after the operation.
Another advantage of anterior hip replacement is the ability to continuously monitor the placement of the prosthetic components with fluoroscopy during surgery. This reduces the risk of errors and decreases the risk of dislocation. Additionally, better alignment is achieved, resulting in a longer lifespan for the prosthesis.
Lastly, one of the most important advantages of anterior hip replacement is the lower risk of hip dislocation compared to other surgical methods. This is primarily because the muscles are not cut during surgery, and anatomically, the risk of the prosthesis dislocating backward is higher. Since the structures at the back of the hip are not cut, the prosthesis is placed much more securely.
Postoperative Period for Total Hip Replacement
Patients can start walking on the first day after surgery. Within the first 15 days, most patients can stop using crutches and walk without support.
Patients can typically start driving after 2-3 weeks and participate in light physical activities (such as cycling, jogging, or swimming) after 1 month. After 2 months, patients may engage in activities like squats, golf, and light-paced tennis.
Who is Suitable for Anterior Hip Replacement Surgery?
Anterior hip replacement is particularly preferred for relatively younger patients who require hip replacement, those who are expected to have more active post-surgery sports activities, and patients who are not severely overweight. It is not a suitable method for patients with hip dysplasia requiring shortening hip replacement, patients who are very overweight (BMI 35 and above), or patients needing revision hip replacement.
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