Minimally Invasive Anterior Total Hip Replacement

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What is minimally invasive anterior total hip replacement?

Minimally invasive anterior total hip replacement is a surgical technique used to replace the hip joint through a small incision at the front (anterior) of the hip, rather than the side or back. This approach may provide superior stability for the artificial joint, as well as minimising disruption to surrounding muscles and soft tissue, often resulting in less post-operative pain, faster recovery, and quicker return to normal activities compared to traditional hip replacement methods.

Indications and contraindications for minimally invasive anterior total hip replacement

Minimally invasive anterior total hip replacement is typically employed for the treatment of:

Severe osteoarthritis: to alleviate pain and dysfunction caused by advanced osteoarthritis of the hip.

Rheumatoid arthritis: where damage to the hip is severe.

Hip fractures: including those involving the hip socket or where there is extensive damage to the femoral head.

Hip dysplasia: resulting in structural abnormalities within the hip.

Avascular necrosis: where compromise of the blood supply has resulted in bone death and the collapse of the hip joint.

Developmental deformities: resulting in hip pain and dysfunction.

Contraindications for Complex Primary Hip Replacement include:

Active infection.

Obesity.

Poor General Health, including uncontrolled heart disease or severe lung disease.

Allergies to the material of the implant.

Non-cooperation with clinical instruction.

Prior abdominal surgery which make access to the hip joint difficult.

Inability to achieve position on the operating table due to physical limitations.

Benefits and complications of minimally invasive anterior hip replacement:

Benefits

Typically involves a smaller incision, resulting in less tissue damage, reduced scarring and better cosmesis.
Rapid recovery compared to traditional hip replacement approaches.
Reduced trauma to muscles and tendons.
Reduced pain.
Improved hip range of motion.

Known complications

Post-operative infection
Deep vein thrombosis (DVT) and pulmonary embolism.
Wear and loosening of the implant, requiring revision.
Nerve injury
Vascular injury and bleeding.
Dislocation of the hip, requiring reduction
Muscle weakness, joint stiffness, or instability.
Allergic reaction

The surgery

The anterior approach involves accessing the hip joint from the front rather than the side or back (lateral or posterior). It does not require the cutting or detaching of muscles from the pelvis or femur, enabling a quicker recovery.

Preparation prior to surgery

You will receive a thorough health assessment: including medical history. You may be advised to modify certain lifestyle factors and you may be referred to another specialist. You may be asked to stop taking certain medications as your surgery date approaches. X-rays, CT scans, and MRIs will be used to evaluate your condition and plan your surgery.
Skin and bowel preparation: On the evening before your surgery, you will be asked to wash your leg using the sponge provided at your pre-admission clinic. A skin test may be administered if an iodine allergy is suspected. You will also be provided medicine to help you evacuate your bowels prior to surgery.
Patient education: if neccessary, you may speak with a physiotherapist who can advise you on post-operative mobility.

On the day of the surgery

You will be asked to complete your surgical paperwork and will meet with the anaesthetist.
The surgical site will be prepared.
You will be administered general or spinal anaesthesia.
An incision will be made at the front of the hip, typically 4in in length to allow access to the joint.
Working through the muscle planes to minimise trauma, the joint is exposed and the damaged socket and femoral head are removed.
Prosthetic components are implanted into the target areas.
The wound will be sutured and dressed.

After your surgery

Wound care: your incisions will be closed with sutures and covered by a waterproof dressing. After 14 days, the sutures will be removed. Prior to this, you may clean the wound gently with warm water and soap, being careful to dry it thoroughly.
Pain and swelling: You may experience mild to moderate pain in the hip and groin. You will be prescribed painkillers to manage these symptoms. Immediately following surgery, you may experience some numbness, although this will resolve without intervention. Inflammation can be controlled by icing (15 minutes per hour maximum) during the first week.
Mobilising: Weightbearing will be increased gradually, under supervision. Crutches may be used initially and non-impact exercises with a physiotherapist, designed to improve strength, flexibility and range of motion, may commence later. High-impact activities should be avoided during healing. You may required assistive devices, including grab bars or a raised toilet seat, to improve mobility at home.
Aftercare: after 6 weeks, you will be asked to complete further X-rays to assess healing, and at three, six and twelve months after your surgery for the same reason. You may be prescribed blood thinners to reduce the risk of a clot developing.

Concerns

If you are concerned about your pain level, or develop significant bleeding, fever or redness around the surgical site, please contact us immediately. For after-hours support, contact the hospital at which your surgery was completed. They will contact Prof. Al Muderis on your behalf.

Norwest Private Hospital: (02) 8882 8882

Macquarie University Hospital: (02) 9812 3000

This treatment could be eligible for our No 'Out-of-Pocket' Expenses Program

For further information, click here or to check your eligibility, please contact our team.