How will I know I’m ready for a hip or knee replacement?

I typically tell patients that they should schedule an appointment when their hip or knee pain directly inhibits their function and quality of life. Don’t let pain dictate your quality of life: make an appointment with an orthopedic surgeon and educate yourself on possible treatment options that can restore pain-free function and lifestyle.

Every patient’s story is different. My job as a surgeon is to educate patients on their pathology, provide them with as many options to manage their pain and functionality, and work with them to come up with a treatment plan. 

There are many conservative treatment options to treatment mild to moderate arthritic symptoms including NSAIDs, gel injections, cortisone injections, bracing and activity modifications.

Only when a patient is refractory to conservative care do we discuss potential surgical intervention. 

What is an Anterior Hip Replacement?

An anterior hip replacement refers to a specific approach used to implant your hip prosthesis. The approach is muscle sparing and essentially moves the muscle out of the way to implant the prosthesis versus cutting through the muscle in the more traditional posterior and direct lateral approach.

What are the advantages of the Anterior Hip Replacement?

Advantages of anterior hip approach include a muscle sparing technique allowing the surgeon to preserve muscle attachments rather than cutting through them in traditional direct lateral or posterior approach. The incision is usually 6 inches in length on the anterior thigh as opposed to a traditional 10 inch incision of the buttock. 

Intra-operatively, the anterior approach allows the surgeon direct visualization of the cup placement, stem size and position. Position of cup and is crucial for the longevity of the implant and reduces technical error which can lead to dislocation or early wear. Surgeons are also able to use radiographic markers to assess leg lengths minimizing the risk of a leg length discrepancy post operatively.

Other advantages include shorter hospital stay compared to traditional approach. An average length of stay for an anterior approach is 1-2 days versus 2-4 days for traditional approaches. In my experience, there is less narcotic use and earlier mobility in the anterior hips allowing for quicker rehabilitation.

In my practice, there is a much faster recovery period for the anterior approach ranging 6-8 weeks. I attribute this to the minimally invasive surgical approach with less muscle damage/trauma. Typical direct lateral or posterior approach recovery is approximately 2-4 months. While the anterior approach allows for quicker recovery, patients with either approach typically reach equivocal functionality and pain scores 8-12 months after surgery.