Considering hip replacement? Learn about your surgical options

Are you experiencing chronic hip pain from arthritis, an injury or another condition? If you answered "yes," a hip replacement may be in your future. When making a decision about a total hip replacement, it's essential to understand your options and the benefits and risks associated with each.

Benefits of a total hip replacement

A total hip replacement can reduce pain and improve your quality of life, range of motion, ability to walk or run, and enhance or help you regain your independence. Many patients enjoy aspects of their lives that they've missed due to limitations caused by their hip pain.

Surgery isn't automatically the first option. That's why it's essential to consult with an orthopedic professional about nonsurgical treatments. With these options, you may be able to temporarily or permanently avoid surgery.

Types of hip surgery

Research suggests total hip replacements are the most successful orthopedic surgery for chronic pain relief. Surgeons use multiple techniques for total hip replacements: anterior, anterolateral (Watson-Jones), transgluteal (Hardinge) and posterior. While all methods are effective, they do have some differences.

Regardless of the technique, the advancements in hip replacement components, surgical instruments and robotic assistance during all hip replacement approaches allow for better, longer-lasting solutions.

Anterior surgical approach

The anterior approach to total hip replacement is when the surgeon enters through the front of the upper thigh. Working between the muscles eliminates the need to detach them from the bone, often called a muscle-sparing approach. The anterior approach is performed with the patient lying on their back, which aids X-ray guidance and robotic assistance and increases the accurate placement of prosthetic hip components.

Typically, patients who undergo this procedure can expect slightly faster recovery, gait improvements and less need for walking aids. However, every patient is different, and recovery depends on factors such as body type and lifestyle. Patients who are active, in good physical shape and younger are often the best candidates for an anterior approach hip replacement.

Learn more about the anterior surgical approach in these videos and how it may benefit you:

Anterolateral (Watson-Jones) approach

With the anterolateral approach, the patient typically lies on their side, and the surgeon approaches the hip on the side and then around the front. The hip is opened between the gluteus medius, a muscle on the outside of the pelvis, and tensor fascia latae muscles, which are small muscles just in front of the hip joint. In most cases, the surgeon must cut at least a small portion of the gluteus medius muscle to provide better access to the hip joint.

Posterior surgical approach

Over the past few decades, a posterior approach has become the most common approach for hip replacement. The surgeon enters just behind the side of the hip bone, which can provide greater exposure to the pelvic bone and femur. The posterior approach is typically recommended for revision surgeries.

Transgluteal (Hardinge) approach

The transgluteal approach positions the patient on their side and the surgeon reaches the hip through the side. The surgeon opens up the hip joint by removing the front portion of the hip abductor muscles, also known as gluteus medius and gluteus minimus, from the greater trochanter, which is located on the femur, or thigh bone. This is a more extensive approach that gives broader access to the pelvis bone around the hip socket and the femur. It tends to have the lowest risk of future dislocation, but the patient may have a persistent limp due to weakness in the hip abductor muscles.

Total hip replacement risk

As with all surgeries, hip replacements come with certain risks. However, specialized surgical training, advanced technology and years of research have significantly limited the number of complications.

Risks from this surgery may include:

• Blood clots
• Infection
• Fracture
• Dislocation
• Change in length of your leg
• Loosening of joint replacement components over time

When to consider hip treatment

Talk to your orthopedic professional about hip treatment options, if you're experiencing:

• Regular pain in your groin and front of your thigh
• Pain that limits your activity and wakes you up at night
• Difficulty putting on shoes and socks
• Challenges bending at your hip
• Lack of relief provided by over-the-counter medications and lifestyle changes

A total hip replacement can be a positive step for your well-being. However, you need to be confident that it's right for you. Your orthopedic team will answer your questions, help you reach the best possible recovery and enhance your quality of life.

Next steps:

• Find an orthopedic surgeon near you.
• Learn about advancements in joint replacement.
• Read about a patient's experience with having both hips replaced.
• Learn more about orthopedics and orthopedic surgery.
• Learn how physical therapy sessions can aid your recovery.
• Watch this patient video about anterior approach replacement:
  

Jacob Ziegler, M.D., is an orthopedic surgeon in Mankato, Minnesota, who specializes in anterior approach total hip replacement.