Minimally Invasive Revision THR-Anterior Approach

Total hip replacement is surgical procedure where a part of or the entire hip will be replaced with an artificial device. Revision total hip replacement (THR) surgery is a procedure where the previously performed hip replacement surgery requires revision that may range from minor adjustments to substantial replacement of bone. You will be a candidate for revision THR if you are experiencing pain or have dislocation, loosening of the femoral or acetabular component, infections, or osteolysis.

The revision THR can be performed using anterior approach or posterior approach. Anterior approach is reaching the hip bone from front-side of the hip whereas reaching through side or from back are the lateral and posterior approaches, respectively. Smaller incisions are made in the hip region; dissections are made between the muscles exposing the hip bone. Hip bone is separated from the acetabulum, old plastic liner will be removed, acetabulum will be prepared using extra bone or metal, and the metal shell will be fitted into the space using screws. New plastic liner will be fitted into the metal socket, femur bone component is cleared of any old cement, new femoral component is pressed or cemented and wires may be used to hold the fittings tight. A metallic or ceramic ball is placed on femoral component then the ball and socket are fixed that forms new joint. Muscles and tendons are sutured.

Anterior approach helps is preserving the muscles, the gluteal muscles, attached to the pelvis and femur. Anterior approach leaves these muscles undisturbed whereas both lateral and posterior procedures damage the gluteal muscles and the nerves attached to it causing further complications. Furthermore, the minimally invasive procedure offers other benefits such as smaller incisions, minimal blood loss, and quicker recovery. Also, patients undergoing minimally invasive anterior THR can bend their hip, bear full weight and restore to their normal functions faster as compared to those undergo posterior or lateral approach.