A total hip replacement has been termed the “operation of the century” because it provides reliable and durable pain relief for patients afflicted with osteoarthritis and other conditions. The improvements in quality of life are due to development of high quality implants that replace the arthritic hip joint through accurate placement into the patient by expert surgical technique.
However, as patients continue to demand more activity and function after hip replacement surgeons, hospitals and implant manufactures began popularizing a surgical approach called the “direct anterior approach” where the hip replacement is inserted through the front of the hip, as opposed to the traditional approach where an incision is made on the side of the hip and the implants inserted through the back of the hip (posterior approach).
Some claim that the direct anterior approach has a faster recovery and less pain compared to the most accepted traditional minimally invasive approach, termed “posterior approach”. Unfortunately, the claims made in the lay press, on the internet and by some hospitals, surgeons and implant manufacturing companies are misleading and inaccurate.
“If It Sounds Too good to Be True, It Probably Is”
Dr. Meneghini and colleagues at leading hip and knee replacement centers in the U.S. have recently published pioneering work highlighting risks that may be associated with the direct anterior approach. Risk of early failure in hip replacement from implant loosening (failure to anchor to the bone) and early fracture (breaking of bone) is associated with the anterior approach, compared to the posterior approach which has much lower rates of those failure modes. Dr. Meneghini and his co-authors reported these research findings in the most prestigious clinical orthopaedic journal, The Journal of Bone and Joint Surgery1, in early 2017. Dr. Meneghini and colleagues’ research was further supported by research from orthopaedic surgeons at Stanford in a separate publication in the Journal of Arthroplasty2. This research has been reported in the orthopaedic surgery professional media outlet, Orthopedics This Week3.
Choose your SURGEON…don’t choose your surgical approach.
The secret that everyone in medicine knows is when it comes to your medical care, especially for surgical procedures, the best surgeons are the ones that people in the medical field chose for their surgical procedures. When doctors and nurses are patients and need surgery, they don’t search the internet for the latest marketed surgical approach, like the direct anterior approach. Rather, we ask other doctors and nurses who they recommend as the best surgeon that has the best surgical skill, outcomes and does a high volume of the procedure we need. We recommend you as a patient and consumer, ask those you may know in the medical field what surgeons are the most skilled at total hip and knee replacement…that is what we do for ourselves and our families!