By Dr. Leone
There are many well-established surgical approaches to the hip. Two surgical approaches for total hip that have gained recent notoriety are the direct anterior approach and the minimally invasive or mini-posterior approach.
The direct anterior approach involves splitting the fibers between the two main muscles located at the front of the hip and working through the natural interval between the muscles.
Advantages of the Anterior Approach
- Because the anterior approach avoids cutting through muscle, it is hoped it will lead to a quicker recovery. This has not yet been show to be true or false through scientific study. Most agree that any short term benefits are not apparent after the initial healing period.
- Some feel the approach is more minimally invasive than other approaches, but honestly, the definition of minimally invasive is not clear or agreed upon. It is not related to the length of the incision, which is about the same for both approaches.
- The hip dislocation rate may be lower due to the preservation of the muscles at the side and the back of the hip.
- The hip socket is exposure is straight forward.
Disadvantages of the Anterior Approach
- Nerve injury is possible, which decreases sensation to the outside of the thigh.
- There is an increased risk of complication on side of the hip where the femur is located due to increased difficulty in exposing and visualizing the femur.
- It is difficult for the surgeon to see enough of the femur to fix a fracture if it were to occur. With some femoral fractures, it would be necessary to abandon the approach and expose the femur through a different approach using a new incision.
In my next post, I will list the advantages and one main disadvantage of the mini-posterior approach. In the meantime, feel free to join the discussion by leaving a comment or question below.