Anterior hip replacement

Published 11:23 am Tuesday, July 25, 2023

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No one wants surgery, but when joint pain becomes unbearable, surgery may be your best last resort for restoring long-term quality of life. And the five-star surgeons at St. Luke’s Orthopedic and Sports Medicine in Columbus, NC, have earned a reputation for superior patient experience, much higher than the national average.

Patients travel great distances to have their orthopedic surgeries at St. Luke’s. Dr. Azar and Dr. Cadier have performed thousands of knee, hip, shoulder, and sports medicine procedures. By adhering to strict pre-operative planning, surgery protocol and post-operative rehabilitation, patients experience reduced infection rates, managed post-op pain, and superior recovery. And as a result, there is a reduced risk of dislocation, blood loss, tissue damage and muscle trauma.

For this article, we will focus on direct anterior hip replacement.

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Diseased arthritic joints or traumatic injuries are the primary cause of joint replacement surgery. Indicators of arthritis in the hip may be pain in the groin area and joint stiffness when walking. 

There’s no rush to have joint replacement surgery. Your pain level will dictate when it’s time for the replacement. We prefer to exhaust conservative treatments like anti-inflammatory meds, lifestyle modification, or physical therapy before recommending joint replacement. While many conservative treatments are available for hip arthritis, cortisone shots are not an effective long-term solution for arthritic hip pain. If you opt for a cortisone shot for hip pain, you must avoid receiving surgery for three months to avert the increased risk of infection.

Today hip replacement surgery is a prevalent procedure. The National Center for Health Statistics suggests that more than 400,000 hip replacements are performed annually in America. Most who receive hip replacements are between sixty and eighty years old—when arthritis has taken hold. However, younger people who experience traumatic hip injuries or suffer from autoimmune diseases may develop hip arthritis and require earlier interventions.

At St. Luke’s, we offer both anterior and posterior procedures. The incision for the direct anterior approach is “muscle sparing,” meaning we do not cut the muscles and tendons to reach the damaged joint. Dr. Azar gently pushes muscle groups and ligaments aside, removes the diseased or injured joint, positions the new implants, and then moves the muscles and ligaments back into place.

Initial recovery post-surgery is quicker, hospital stays are often shorter, the patients usually have less pain, and rehabilitation occurs at an accelerated rate over the traditional approach.

Because not all patients are candidates for the direct anterior approach, we do offer the posterior procedure. This technique involves making an incision on the back of the hip. Muscles and tissues are detached during the posterior approach so the surgeon can reach the hip joint. The abductor muscles (the major walking muscles) are not cut.

High-level orthopedic studies have shown that total hip replacement via anterior hips recovers faster and uses fewer pain medications in the first two weeks than the posterior approach. At the same time, the anterior approach can have a higher incidence of nerve injury that, in most cases, is restored over time. Long-term outcome studies have shown no clinical difference in function, patient satisfaction, or implant longevity between the two approaches.

Successful hip replacement surgery depends on many factors. Of course, the knowledge and skill of the surgeon are critical; the type of hip prosthesis, your weight and build, and your willingness to participate in pre-op preparation and post-op rehabilitation are essential factors.

Hip replacement surgery takes about an hour to complete. At St. Lukes’s, patients are up and walking on the day of the procedure. Physical therapy includes climbing stairs and practicing getting in and out of the car. 

People with more sedentary work environments can typically return to work within six weeks. Those who do more physical work can generally return to work within three months. Hip replacement patients can immediately resume upper-body exercises—however, six weeks of recovery must pass before doing lower-body exercises to prevent tendonitis around the hip.

To learn more about joint replacement surgery at St. Luke’s Orthopedic and Sports Medicine, call (828) 894-3718 or visit