Anterior total hip replacement

Anterior, muscle-sparing approach to hip replacement

The direct anterior approach for hip replacement allows the surgeon to reach the hip joint from the front, instead of the side or back. Unlike other approaches to the hip, the anterior approach means we do not have to detach or disturb muscles from around the hip during surgery. The surgeon works through a natural separation in the muscles to reach the hip. This means less pain for the patient. With this approach the patient is able to immediately bend the hip freely with no restrictions, and can bear weight as tolerated right away, which leads to a faster, short-term recovery. 

Surgical procedure

The Hana® table is a special table used for the surgery. It allows for hyperextension and rotation of the hip to allow access to the thigh/femur for component positioning. The carbon fiber make-up of the table also allows the surgeon to use x-ray during the case to assist with component positioning and leg-length measurements, whichis not possible on a regular table. 

A small incision is made over the front part of the thigh. This minimizes the scar and pain from surgery.


Surgical steps:

  1. Damaged bone removed: The damaged head part of the femur/thigh bone is removed. This allows access to the cup/hip socket. 
  2. Hip socket cleaned: Damaged bone and cartilage are removed from the hip socket.
  3. Metal cup inserted: Using real time x-ray, the surgeon places a metal cup within the hip socket; x-ray allows for precise placement.
  4. Liner inserted: A polyethylene liner is locked within the cup and the replacement hip socket portion is now complete.
  5. Femur/thigh bone prepared: The surgeon utilizes the Hana® table to extend and rotate the femur exposing the end of this bone. Special instruments are used to prep this bone for implant.
  6. Femur/thigh implant placed: Using real time x-ray again, the surgeon places the titanium stem within the femur in the best position possible. A ceramic ball is placed on top of this stem, to replace the damaged head.
  7. Hip relocated: The new ball and socket parts are relocated to form a new hip joint. 
  8. Final x-rays taken: The surgeon takes final x-rays to insure appropriate leg lengths.
  9. End of procedure: The natural part in the muscles is allowed to fall back into place naturally. The incision is closed with sutures and a special dressing that allows the patient to shower is placed right over it. 
  10. Aftercare: Typically, an overnight hospital stay is required. Patients receive physical therapy and go home the following day. 


Faster recovery, less pain

  • Smaller incision and scar
  • No detachment or cutting of muscles from the hip meaning less pain
  • Decreased risk of dislocation
  • Quicker short-term recovery
  • More precise placement of components with intra-operative x-rays, allowing more accurate leg length and longevity
  • No "hip" precautions typically after surgery