How long is anterior hip replacement surgery

Your surgeon will discuss which approach might offer the best result. When the surgery is minimally invasive, the surgeon accesses the hip joint though one or two small incisions by moving the muscles aside. This approach may have advantages, such as:. Minimally invasive hip replacement is not appropriate for all patients.

Your age, weight, fitness level and other factors will help the surgeon decide if you are a good candidate. A traditional hip replacement includes a single, large incision that helps the surgeon gain access to the hip, usually through the side lateral approach or from the back posterior approach.

Recovery from a traditional hip replacement can take time, because the surgeon needs to cut through or detach some muscles and tendons to get to the joint. The muscles and tendons are repaired when the hip implants are in place. The surgical approach your doctor will recommend depends on several factors, including how the surgeon will gain access to the hip, the type and style of the implant and how it will be attached, and your age and activity level, and the shape and health of the hip bones.

The likelihood of future surgery also figures into the decision, because some surgical approaches and types of implant attachment can make a revision surgery easier or more challenging. As part of the evaluation for surgery, your orthopaedic surgeon will discuss the options of minimally invasive surgery or traditional hip replacement, as well as how he plans to perform the surgery and what type of implant will be used. The Johns Hopkins hip and knee replacement program features a team of orthopaedic specialist highly skilled in joint replacement procedures.

Our team will guide you through every step, from pre-surgical education to post-surgical care and physical therapy. Our goal is to return you to your desired level of activity as soon as possible.

Both uncemented and cemented approaches can work well to secure the implant. As hip replacement techniques have evolved over the years, the cement used has improved, as have methods to encourage natural bone re-growth. For some hip replacements, the surgeon will combine methods. He or she might prefer to use cement on the femoral stem while using an uncemented attachment on the socket piece that fits into the hip bone.

Both left and right hips can be replaced during a single surgery. A double hip replacement is also called a bilateral hip replacement. If you are having issues with both hips, your doctor might recommend a double hip replacement if you are in good health and can tolerate a longer surgery and a more challenging recovery.

Hip replacements are performed in a hospital or surgery center. They are often considered outpatient procedures, even though you might need to stay a night or two for observation or to resolve complications. On average, hip replacement surgeries last about two hours. A partial hip replacement might require less time, and a double hip replacement may take longer. Complications during surgery might also extend the surgery time.

You may need imaging, such as an X-ray, immediately after the procedure and during recovery, to confirm that your surgery was successful and that your new hip is healing well. Hip replacement recovery starts right away. You will be encouraged to get up and move around as soon as possible after surgery.

Some patients might spend time in an inpatient rehabilitation unit to prepare for independent living at home.

Whether you go home or to a rehabilitation unit after surgery, you will need physical therapy for several weeks until you regain muscle strength and good range of motion. The surgeon, physical therapist or occupational therapist can advise you on when you are ready to walk with or without assistance, and how to manage your pain.

The provider will discuss your rehabilitation needs, what to expect in the days and weeks ahead, and how to make the most of your recovery.

Your motivation and cooperation in completing the physical therapy is critical for an effective recovery process and overall success of the surgery. Some fluid might drain from your incision. This is normal during the first few days after surgery. Also contact the office if your pain is not improving. Most patients do well with hip replacement. As with any surgical procedure, there are some risks during and after a hip replacement:.

In very, very rare cases of bone surgery, particularly procedures using cement, an embolism blockage can occur if fat from the bone marrow enters the bloodstream. A fat embolism can raise the risk of a heart attack or stroke. Dec 21, Patient. This article was reviewed by Dr. Nima Mehran, M. D and Orthopedic Surgeon and Dr.

Trevor North, M. D and Orthopedic Surgeon. This question is actually a bit of a joke because with a spinal block, you may not go under at all…Ba Dum Si!

How long does hip replacement surgery take to perform? The average hip replacement surgery takes just hours to perform. At the hospital, you will be checked-in upon arrival. Here, you will wait for your surgeon and meet briefly before being escorted to the operating room. In the operating room, you will likely be given either: general anesthetic being put to sleep , spinal anesthetic, or a combination of the two.

There are pluses and minuses to the various types of anesthetic but a common preference by care teams is to go for spinal anesthetic with sedative medication. A spinal block is administered with medication to help your relax. Spinal blocks have lower risk for serious complications than general anesthetic, cause less nausea, and let the patient breath on their own during the operation. A huge perk for a spinal block regional anesthetic : pain is blocked for up to 24 hours following surgery.

The incision will cut through the skin, tissue and muscles at the top of your thighbone, allowing your surgeon to gain access to your hip bone.

The first step is generally dislocating your hip pulling the ball out of its socket. Next, the ball-shaped head of your femur upper thigh bone is removed.

A metal stem is placed within the femur and a metal socket is placed within the pelvis. A ceramic or metal ball is then placed on the stem and a dense plastic bearing is placed within the socket. The artificial ball and plastic bearing are extremely smooth, which allows the hip to function and move similar to a normal hip. The major advantages of direct anterior hip replacement in comparison to traditional approaches include a more rapid recovery, less pain in the immediate post-operative period, more normal gait mechanics, and a more stable artificial hip without the need for hip precautions.

Regardless of surgical approach, the most important factor in terms of technical success involve placing the hip replacement components in a optimal position. The most effective and reliable surgical treatment of severe arthritis remains total hip replacement. The other surgical option for severe arthritis is hip resurfacing, which may also be very effective and has the advantage of being more bone conserving i.

Hip resurfacing has fallen largely out of favour recently in the United States because the bearing surfaces used are "metal-on"metal". Although this may be an effective bearing surface, some adverse effects have been seen in certain designs that are very sensitive to component malposition.

Direct anterior total hip replacement is an option for most patients with severe arthritis of the hip. Patients may not be suitable candidates for the direct anterior approach if they have abnormal anatomy i. For most patients who have hip arthritis, pain is also a significant limitation. Pain is a fairly subjective measure however, and some patients who have a high pain tolerance may be able to live with pain for many years.

For most patient, quality of life is the most important factor in making a decision towards surgery. The natural history of denegeratie arthritis is that symptoms tend to progressively worsen over time. Arthritis may have a "waxing and waning"pattern, with good days and bad, but over the course of time, symptoms have a tendency to become persistent. Typically the progression is slow, generally over several months or years, but this is generally very difficult to predict.

Arthritis is not a life threatening condition however. There is, generally speaking, never a "need" to have surgery for arthritis like many forms of cancer for example. Arthritis which prevents a patient from being active physically i. Because the tendons aren't detached from the hip during direct anterior hip replacement, hip precautions are typically not necessary. Success is generally defined as a significant improvement in pain, in increased ability to function normally, and an improvement of quality of life.

Direct anterior total hip replacement aims to improve on traditional hip replacement but minimizing muscle and tendon trauma. This has been reported to results in more rapid recovery, less early post-surgical pain, more normal gait mechanics, and a more stable artificial hip.

This effect may last up to 2 years, but after this time point the differences are harder to distinguish. In very rare occasions, the severity of arthritis may be so bad that bone begins to be lost, which may effect the technical reliability of an operation. In these circumstance, surgery may be recommended with more urgency. Because surgery is elective, patients should be instructed to be as healthy as possible prior to surgery in order to decrease the likelihood of complications.

This includes:. The risks of total hip arthroplasty include but are not limited to the following: infection, injury to nerves or blood vessels, fracture, stiffness or instability of the joint, loosening or wear of the artificial parts, and leg length discrepancy. Medical risks include but are not limited to: risk of anaesthesia, heart attack, stroke, blood clots in the legs or lungs, and blood transfusions. An experienced total joint surgeon will use specialized techniques to minimize these risks, but unfortunately they can never be eliminated.

The major risk the direct anterior total hip replacement minimizes in comparison to tradition approaches is the risk of instability or dislocation ball and socket separating.

This is because the major stabilizers of the hip joint are the muscles and tendons on the back of the hip posterior structures and the side of the hip abductors , neither or which are violated with a direct anterior approach. Because of this, traditional hip precautions e.

Many of the risk of total hip arthroplasty can be managed effectively if they are promptly identified. Infections, though rare, are extremely serious complications that must be managed early and aggressively. Any deep infection involving a total hip replacement must be managed with surgery. This may as simple as washing out the infection and replacing the ball and plastic liner, or may be as complicated as removing all of the components and placing a temporary hip replacement made of antibiotics.

Total hip dislocations typically involve a "reduction" of the dislocation joint in the emergency department, but also may require surgery to correct depending on the underlying problem. Fractures, though undesirable, rarely affect the outcome of an operation if identified and treated at the time of surgery.

Nerve and blood vessels injuries are extremely rare 1 in roughly , but can be devastating complications. Loosening of components is a possibly of any mechanical device. Surveillance of implant through x-rays typically every 2 years may help minimize this risk.

Total hip replacement is a "quality of life" operation, not a life saving operation. Hip replacement surgery can therefore be delayed to any time which suits a patients personal timeline for recovery. In rare cases where there is significant progressive bone loss i.

For patients who are employed, the timing of surgery is often more important that someone who may be retired. Direct anterior total hip replacement may allow you to do desk work immediately, although many patients require 2 weeks before they feel comfortable enough to do this full time. More intensive work or return to sports require anywhere between 6 weeks and 3 months before possible. Direct anterior total hip arthroplasty is a technically demanding operation, generally considered more so than the traditional approaches.

The benefits may be significant, particularly for active patients , but should never come as a compromise to the expedience, reliability, and precision of the operation.

Direct anterior hip replacement should be performed by a surgeon experienced in this approach, either through fellowship training or through cadaveric exercise. You should ask your surgeon about their experience, volume, and training with this approach. Direct anterior total hip arthroplasty is a technically demanding procedure; each step plays a critical role in the outcome.

After the anesthetic has been administered and the skin is sterilely prepared, an incision is made in the front of the thigh over the hip joint, typically 3 cm from the thigh crease. The typical length of an incision is 3 to 4 inches, although this may vary depending on the size of the patient. The advantage of the direct anterior approach over traditional approaches is that an intermuscular, internervous tissue plane is used.

This mean that rather than cutting muscles and tendons to access the hip joint, natural tissue planes are used, allowing the muscles to be moved, rather than cut. Once the hip joint has been fully exposed, the arthritic femoral head is removed using surgical instruments. The socket acetabulum of the hip joint is then cleaned, which involves removing bone spurs and excess tissue within the socket.

Hemispheric reamers are then used to remove the damaged cartilage and reshape the arthritic acetabulum to accept the metal acetabulum. A metal artificial acetabulum is then impacted in to the prepared socket. A plastic bearing highly cross-linked polyehtylene is then impacted and locked into the metal socket. The femur is then prepared.

This involved placing series of progressing larger broaches sharp rasp like instruments with the same shape of the femoral stem into the canal of the femur until a tight fit is achieved. A trial head is placed on the final broach, and the hip is reduced. The stability of the hip is checked at this time throughout a range of motion and leg lengths are measured.