There are several different ways of performing a total hip replacement. By far, the most common surgical technique involves a posterior incision ranging anywhere from 3-1/2 to 6 inches over the posterolateral corner of the buttock. This is utilized in approximately 70% of cases performed in the United States. There is very little muscle damage utilizing this approach, and the procedure is associated with excellent outcomes from multiple authors.
The next most common approach is a direct lateral procedure, which involves some detachment of muscle and therefore requires some protection during the first four weeks of post-surgery healing. This is utilized in approximately 25% of cases in the United States. Once again, excellent results have been documented with this approach, although there is a slightly higher incidence of limping associated with the lateral approach.
The least common procedure is the anterior approach. However, this method has been recently revisited and is currently performed in approximately 5% of cases in the U.S. The anterior approach carries the advantage of being the most direct approach to the hip joint. In addition, it does not require any division of muscle. This approach is technically more demanding and may require a special table to perform. The potential advantage is a lower dislocation rate than the posterior approach and we are currently enrolling patients in a prospective, randomized study to evaluate the differences between the anterior and posterior approachs in patients undergoing total hip replacement.
For more information about replacement surgery, please visit our hip replacement page.
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