This technique involves the use of a single incision. The incision length is 6-10 cm, oriented from the front of the hip at its bottom-most point to the back of the hip at the top. The release of two tendinous structures is performed then repaired at the end of surgery for added stability and restoration of anatomy. The capsule of the hip, a strong thick protective sheet covering the hip joint, is also repaired. An advantage to the use of this approach is the absence of disruption of any of the gluteus medius muscle, a significant hip abductor and stabilizer for the joint.
After surgery, most patients are admitted for a period of 2 to 5 days. Patients may expect to put weight down on the leg immediately after surgery. Instruction is given on how to restrict movement to protect the hip until full tissue healing occurs, approximately 12 weeks after surgery. Patients may progress from a walker assistive device to crutches in the 1-2 weeks after surgery and may resume driving at two weeks.
Like the posterior-lateral approach, this technique involves use of a single incision that is 6-10 cm. The incision is oriented longitudinally over the hip on the affected side. A portion of the muscle or bone is temporarily removed from the front of the femur bone to expose the front of the hip joint. Likewise, the hip capsule, the strong thick covering over the hip joint is opened to expose and work within the joint. Both the hip capsule as well as the muscle or bone tissue are repaired to the original position at the conclusion of surgery. An advantage to this technique is the potential for a slightly lower dislocation rate, as several published studies have demonstrated. Some patients are better candidates for an anterior-lateral approach. For specific situations, such as muscular weakness, or predilection for falling that may apply to you as a patient, consult with your physician.
Post-operative care and rehabilitation is identical to the posterior-lateral approach. After surgery, most patients are admitted for a period of 2 to 5 days. Patients may expect to put weight down on the leg immediately after surgery. Instruction is given on how to restrict movement to protect the hip until full tissue healing occurs, approximately 12 weeks after surgery. Patients may progress from a walker assistive device to crutches in the 1-2 weeks after surgery, and may resume driving at two weeks.
Technology has been available for many years in Europe, and now in the U.S. for a more limited resurfacing of the diseased portions of the hip joint, without complete hip replacement. Now performed in a number of centers across the United States, the diseased femoral head is resurfaced only on its dome, while the acetabular cup in the pelvis may be either replaced with a metal-lined cup or left intact. The amount of bone taken for this procedure is much lower, thus allowing the possibility of future revision replacement, should it be necessary, to be as simple as the original surgery.
The bearing surfaces in this technique are polished metal on polished metal. A number of advantages are realized with this surface option, including far lower wear rates, and the lack of polyethylene debris particles in the joint over time. Because the surface exhibits much lower wear rates, larger head and cup sizes may be utilized, resulting in a more stable hip joint and lower likelihood of such complications as dislocation. This technology is currently available, and patients are recommended to consult with their physician about suitability.