Overview Direct Anterior Approach Total Hip Replacement

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Take Action against your Hip Pain

If you have experienced hip pain, chances are you have probably told yourself it is just part of getting older. If other treatments simply aren’t working and you frequently have hip pain that keeps you from getting a restful night’s sleep, walking up stairs and the activities you enjoy, the Anterior Approach hip replacement surgery may be an option. Read on to find out more about the potential benefits of this procedure.


Potential Benefits of Hip Replacement

  • Pain Relief
  • Improved Mobility
  • More freedom to pursue everyday activities, such as walking and climbing stairs

 

 

Hip Anatomy

A joint is a point where multiple bones meet and work together so that you can perform daily tasks like sit, climb stairs and walk comfortably. The hip joint is described as being a “ball and socket” joint due to the joint’s appearance of a ball (femoral head) fitting snugly in a cup-like socket (acetabulum). The ball (femoral head) is located at the top of the thigh bone (femur) and the socket (acetabulum) is part of the pelvis. The area where the bones meet is covered by a slick but firm tissue called cartilage, allowing the joint to move smoothly.  

 

Hip Replacement Overview

All total hip replacements have the same goal: remove the portions of damaged hip joint and replace them with an implant. The implant used is made up of several different components. The individual components are available in many different sizes and materials so that your surgeon can decide which options will be the best fit for your individual needs. These include:

  • Stem: Inserted into the thigh bone (femur) and anchors the implant in place
  • Ball: attaches to the stem and recreates the ball (femoral head)
  • Liner: recreates the smooth cartilage and allows the new ball (femoral head) to glide and rotate
  • Cup: recreates the hip socket (acetabulum)

 

Direct Anterior Approach Overview

The surgical approach (sometimes called the surgical technique) is the way the surgeon makes their incision so that they can operate on the bones that make up the joint. Most surgeons use what is called the traditional approach, but more are starting to use the Anterior Approach.


Direct Anterior Approach is a relatively new technique in the Southeast Asia region and requires extensive training and expertise. Dr.Phonthakorn Panichkul of the Hip and Knee Center indicates that “Currently, this technique is widely utilized with a high percentage of success in the United States, Canada, and Europe. However in Thailand, with the exception of our team at the Bangkok Hip and Knee Center, this procedure is not as yet readily available. We expect the Direct Anterior Approach to become the standard for hip replacement surgery in the near future”.

 

The Goals of the Anterior Approach

  • Accelerated recovery time because key muscles are not detached during the operation.
  • Fewer restrictions during recovery. Although each patient responds differently, this procedure seeks to help patients more freely bend their hip and bear their full weight soon after surgery.
  • Reduced scarring because the technique allows for one relatively small incision. Since the incision is on the front side of the leg, you may be spared from the pain of sitting on scar tissue.
  • Stability of the implant sooner after surgery, resulting in part from the fact that they key muscles and tissues are not disturbed during the operation.
  • The Anterior Approach usually requires less tissue disruption, which may lead to faster rehabilitation.

 

Things to Consider with Your Surgeon before an Anterior Approach Hip Replacement

  • Am I candidate for the Anterior Approach?
  • What are the other hip replacement techniques and technologies available? How do they compare to the Anterior Approach?
  • What are the benefits and risks of Anterior Approach hip replacement surgery?
  • How long will it take to recover and rehabilitate from an Anterior Approach hip replacement surgery?
  • What is my role in recovery and rehabilitation?
  • If I choose to undergo an Anterior Approach hip replacement surgery, will I be able to resume daily activities?

 

Preparing for Surgery

To prepare for surgery you need to:

  • Compile a list for your surgeon of all your medications including over-the-counter medications and supplements
  • Quit smoking for at least two weeks prior to surgery (if you currently smoke)
  • Lose weight (based on your surgeon’s directions)
  • Prepare your home for your return from hospital
  • Discuss your recovery with relative and friends who may be caring for you after you leave the hospital

 

Hospital Stay

During that time, your hip rehabilitation will begin as ordered by your surgeon and physiotherapist. Your physiotherapist may instruct you to:

  • Begin isometric exercise (tighten muscles without moving the joint) a number of times per day while you are still in bed
  • Move your ankle and other joints
  • Understand the do’s and don’ts of joint replacement recovery


Depending on your individual recovery, your physiotherapist may help you start walking with your new hip.

 

Returning Home

Once you return home, it is still important to continue rehabilitation as instructed by your doctor and physiotherapist.

The goals of rehabilitation are to:

  • Improve your muscle strength
  • Increase the movement in your new hip joint
  • Protect your new hip
  • Help you resume most of your normal activities

Rehabilitation takes time and commitment. Each person is different and the length of recovery is dependent on your particular situation, overall health and your rehabilitation. When your surgeon feels you are ready, you should be able to resume some, if not most, of your daily activities. Hip replacements may take three to six months to make a full recovery. 

 

Activity after Surgery

After undergoing hip replacement surgery, it is important you have realistic expectations about the types of activities you may participate in during your recovery phase. These activities may include:

  • Driving
  • Sexual Activity
  • Leisure and Sports Activities
  • Work Activities


Activities that may cause high-impact stress on the implant should be avoided.

 

For Caregivers

One of the important ways to support your loved one is to ensure he or she receives the best medical care possible by acting as their patient advocate. This means asking questions when you don’t understand something, educating yourself, being an active member of your loved one’s care team and seeking guidance from qualified medical professionals. This is especially important when your loved one is not able to communicate with their health care providers on their own.


While a caregiver may not have a medical or healthcare background, his or her day-to-day experiences with a loved one can provide critical information, so it is important to stay involved. Your health care professional may rely on this information in order to care for your loved one.

 

Communicating with Health Care Providers

Avoid communication barriers

  • Talk about how your loved one communicates his/her feelings and concerns – physically, verbally, and emotionally
  • Ask questions when you or loved one have them and make sure you fully understand the information being given to you or the patient
  • Feel comfortable with staff

Your Questions Answered

Here are some common questions people have about hip replacement surgery, rehabilitation, and recovery.

Q: I am a candidate for Anterior Approach hip replacement surgery?

A: Only your orthopedic surgeon can decide if hip replacement is the appropriate treatment for you. You situation will be discussed and the various treatment options available will be provided. The risks and benefits of each will be explained so that an informed decision about your future course of treatment can be made.


Q: Am I too young for hip replacement?

A: Hip replacement is related to need, not age. Total hip replacement surgery is considered to be an effective procedure that can help patients resume a more active lifestyle.


Q: Do I need to take any precautions before future medical procedures?

A: From now on, you must inform any doctors, including dentists, treating you that you have undergone hip replacement surgery. More than likely, antibiotics will be prescribed before a procedure to avoid infection.


Q: I live by myself. To whom can I turn for help during recovery and rehabilitation?

A: You will likely need assistance with your daily activities for several days to a few weeks following hip replacement surgery. If family members or friends are unable to assist you, ask your surgeon about being admitted to a rehabilitation facility for a few days following surgery to get the assistance you need.


Q: How can I help protect my new hip implant?

A: Hip replacements are designed for the normal activities of daily living. Avoiding trauma and high impact activities are helpful in caring for your new hip implant. 


For further information contact the Bangkok Hip and Knee Center

1st Floor (Next to piano hall) BGH Building 
Open Monday-Friday  08.00 – 20.00  | Sat – Sun 08.00 – 17.00 น.
Call. 0 2310 3731, 0 2310 3732 or 1719.