Anterior Total Hip Replacement
Total hip replacement (arthroplasty) is an operation designed for the treatment of advanced arthritis of the hip. Hip replacement can also be performed for other hip conditions such as osteonecrosis (avascular necrosis) of the hip, hip fractures, post-traumatic arthritis, and childhood hip diseases.
There are many different surgical approaches to expose the hip joint. Historically, the operation was done through a posterior or lateral approach to the hip. When the operation is performed through the anterior approach, it can be minimally invasive and muscle-sparing in that it does not involve cutting any muscles around the hip, unlike the posterior or lateral approaches to the hip. When one can avoid cutting any muscles around the hip, the hip joint and implants remain inherently more stable. After exposing the hip, special instrumentation is used to efficiently and securely implant metal and plastic components to replace the hip joint.
Potential benefits of the minimally invasive anterior approach include lower dislocation rates, fewer post-surgery restrictions, less pain, better mobility, shorter hospital stays, and less tissue disruption, which leads to faster rehabilitation. Dr. Rana also uses live x-ray (or fluoroscopy) during the surgery to ensure accurate placement of the implants. This imaging technology during the anterior-approach allows him to more consistently restore equal leg lengths and the native offset of the hip, which leads to a more natural feeling hip. This also results in lower dislocation rates, less pain, and a faster recovery.
This procedure is increasingly being done on an outpatient basis with potential benefits including lower risk of hospital-acquired infections, greater patient satisfaction, and faster recovery at home.
5 Signs you May Benefit From a Hip Replacement
Typically, the vast majority of patients with hip arthritis present with a deep pain located in the groin. The pain is achy in character. In some patients, they will make a “C” with the thumb and hand and place it on the fold at the front and side of the hip, known as the “C-sign.” Rarely, some patients will have atypical hip pain that presents in the posterior buttock.
When patients have severe hip pain, they limit their range of motion to prevent causing discomfort in the hip. With time, the ligaments and muscles about the hip contract resulting in stiffness and loss of motion. The stiffness can limit one’s ability to put on one’s shoes and socks. Many patients with severe hip arthritis will stop wearing shoes with laces and start wearing slip-on shoes or sandals. Also, getting in and out of a car or a low chair may become increasingly difficult. Patients may notice they need to help lift their leg up with their hands to avoid the hip pain. These are all signs, it may be time to have your hip evaluated by Dr. Rana.
As the hip becomes increasingly stiff and painful, it can limit a patient’s everyday activities, including walking, climbing stairs, bending, getting in and out of chairs, getting in an out of the car, and putting on one’s shoes and socks. For patients who used to be active, they may notice their walks are becoming shorter and the trip to the mailbox is getting longer. These are all signs you may have hip arthritis and may benefit from a hip replacement.
As the hip becomes arthritic and painful, a patient may notice he or she is walking with a limp. Because the hip is a weight-bearing joint, the more weight that goes through it, the more pain a patient experiences. In order to avoid the pain, patients may start using a cane (typically in the opposite hand) to offload the hip joint. A patient may also notice, he or she is unable to support one’s full weight on one leg – even with assistance of a wall or cane. Again, these are all common signs of hip arthritis.
Having arthritis can have negative effects on your mental health. It is common to feel depressed due to the fact that you are no longer able to do the things you want to do in life.
The literature shows that patient’s with arthritis can have the rates of depression and anxiety that are between two- and ten-times greater than the rates of the general population. Patients can also find themselves in a never-ending vicious cycle of pain, poor health, and negative mood as the pain from the arthritis incites depression, and the depression makes the pain worse.
A healthy hip joint has adequate space between the head of the femur and the socket (acetabulum). On the pre-op x-ray, the hip on the right of the xray (which is the patient’s left hip) shows signs of severe arthritis including obliteration of the joint space (bone on bone), sclerosis (increased density and thickening of the bone), and osteophytes (bone spurs). The post-op x-ray, shows the patient after a left total hip replacement.
On the pre-op x-ray, the images shows signs of severe arthritis involving the right hip including obliteration of the joint space, sclerosis, and osteophytes. The post-op x-ray, shows the patient after a right total hip replacement.