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Anterior Surgical Approach to Total Hip Replacement A New Technique That Makes Sense

David J. Jupina, M.D.

A common condition in older adults, degenerative hip arthritis, is a condition involving the loss of cartilage on the weight bearing surface of the hip joint. This condition can cause pain, loss of motion and an inability to go about daily activities. Typically, when conservative treatments no longer help in reducing pain, a Total Hip Replacement may become the treatment of choice. You may be a candidate for this surgery if you experience:

  • Pain in the hip that wakes you and keeps you awake at night
  • Little or no relief from hip pain with medications
  • Difficulty walking, especially up and down stairs
  • Difficulty getting up from a chair
  • Not being able to do the activities you enjoy, such as walking, because the activity is too painful

Orthopedic surgeons have been performing total hip replacement surgery for over 40 years. During that time, numerous advances in hip replacement design and surgical techniques have occurred. One of the most recent advances is the anterior surgical approach to total hip replacement, pioneered by Dr. Joel Matta. This particular surgery requires specialized equipment, a ProFX operating table (see photo), allowing the patient to be placed in the correct operative position for an anterior approach to the hip

This minimally invasive “approach” to total hip replacement requires the surgeon to enter through the front of the hip joint, vs. the posterior approach to the hip, as is the case in more traditional hip replacements. With an anterior approach, the posterior
and lateral supporting muscles of the hip (the gluteal muscles) will remain in tact, potentially offering more stability and therefore, a decreased risk of hip dislocation post-surgically. There is generally less trauma with this approach because the incision is approximately 4 inches in length (this may vary depending on patient size).

The advantages to this innovative surgical technique are many and are unique to the technique. Overall there is an immediate stability of the hip with this surgical technique, which allows the patient to potentially experience a decreased hospital stay and an accelerated rehabilitation schedule. Movement restrictions for 6 to 8 weeks, limited hip flexion to no more than 60 to 90 degrees are typical with a traditional hip replacement surgery. Following anterior hip replacement, patients are allowed t bend their hip within their tolerance, and are not encumbered by motion restrictions within their daily activities. This allows for ease in sitting in a chair, getting in and out of a car, or early sexual involvement post-surgically.

Before this surgery is considered, one should meet with your orthopedic surgeon for an examination and discussion to determine whether the patient is indeed an appropriate candidate for the anterior approach technique for total hip replacement. Total hip replacement surgery has had a long history of success with traditional approaches. This innovative
approach will improve our current standards and allow individuals to return to their activities more quickly and with a greater degree of confidence.

David J. Jupina, M.D., has worked extensively with Dr. Joel Matta in Southern California. Dr. Jupina is currently performing the anterior approach for total hip replacement at ValleyCare Health Systems in Pleasanton. Please call our offices today for additional information, to discuss surgical potential or to schedule an appointment with Dr.Jupina.

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