Direct anterior approach in Total hip Replacement with a small incision

ANTERIOR APPROACH

Dr. Ho offers anterior approach for total hip replacements for suitable patients. Anterior approach is a surgical approach to enter a hip joint through the front for the purpose of a hip replacement. There are different approaches to the hip. The common one is the posterior approach, which involves dissection of the buttock muscles to gain entry through the back of the hip.

The anterior approach is also known as AMISĀ® (Anterior Minimally Invasive Surgery), or termed the Direct Anterior Approach (DAA)

The anterior approach finds its way to the hip in between muscles rather than going through them. The incision is smaller (about 10cm). The incision is made over the top of your hip joint in the region of your groin.

Hip Anterior Approach

Ligaments and tendons are preserved so it is possible following a hip replacement to walk once the patient recovered from the anaesthetics after the surgery, fully weight-bearing on your new hip.

The potential advantages of anterior hip surgery include a reduced risk of dislocation, the ability to sit in a normal chair immediately after surgery, the ability to safely travel home by car at the time of discharge and the ability to walk with minimal assistance in the days after surgery.

For older patients, particularly those that live alone, this facilitates a rapid return to independent living. For younger patients, including manual workers this allows a more rapid return to employment.

The anterior approach describes the method of entry to the hip joint. The inside operation of  taking away the worn out and damaged hip joint and replacing it with an artificial one remains the same independent of the surgical approach.


THE OPERATION

A human hip joint is made up ofa ball (the head of the femur bone) and a socket (the acetabulum of the pelvis bone). Osteoarthritis is one of the common conditions which damages this joint creating pain, stiffness and difficulty walking.

Hip Joint Damage


More than 40,000 hip replacements are performed each year in Australia. Total hip replacement surgery is considered safe and effective.

The aim of a total hip replacement is to replace the damaged ball and socket with man-made components.  The components are made from metal and plastic.  Ceramics are also used. The plastic (ultra-high density Polyethylene) used in total hip replacement is extremely tough and resistant to friction and wear.  The metal usually is Cobalt Chromium Alloy, Stainless Steel or Titanium.

Hip Replacement Components


The components are fixed to the bone by using either a type of medical cement (Methacrylate) or by press fit.   The components that work by press fit usually have a layer of coating which will attract bone to grow on it to further secure the fixation of the component.  This new joint is expected to relieve pain, decrease stiffness and restore mobility.  Dr. Ho commonly uses a prosthesis supplied by Medacta. The cup is a Titanium shell and the inner liner is ultra-high density Polyethylene. The stem is either a Titanium press-fit stem or a high nitrogen stainless steel stem fixed by cementing.