Anterior approach versus posterolateral approach total hip replacement.

Anterior approach versus posterolateral approach total hip replacement.

We recently completed our prospective randomized study evaluating the differences between anterior approach and posterolateral approach total hip replacement. There was a statistically significant difference in the amount of postoperative pain, return to work, and function between the two groups. The anterior approach hip recovered faster, got back to work sooner, and had an earlier return of function when compared to the patients in the posterolateral group. At one year, the differences between the two groups seemed to be minimal, supporting the fact that total hip replacement is an excellent operation with very gratifying, long-term results. While there were certain exclusion criteria in the study, such as morbid obesity and age over 75, these groups were otherwise very well matched and similar to the general total hip replacement population. Evaluating these two approaches and having done them both for many years, it is clear that certain patients are better suited for one approach versus the other. Certainly, individuals who have a large “beer belly” or pannus of adipose tissue are less desirable for an anterior approach as it interferes with the exposure and can potentially complicate healing. Certain bone conditions also will favor a posterior approach as there are more options for implant selection. For motivated, more-fit individuals, the anterior approach offers some advantages.

— William P. Barrett, MD

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  1. Johanna Yoder

    I just came across your posts and find them so encouraging and informative. I had THR minimally invasive surgery 9-7-10 and I have a new lease on life. I have exercised most of my adult life and have kept my weight in a good zone. My surgery went well and it was followed by three weeks at home PT and six weeks PT at their facility. Immediately after PT I signed up with a personal trainer who had a physical therapy background. I worked with her for five months. She facilitated my amazing transformation to a strong, fit 64 year old. The squats and lunges done under the supervision of a personal trainer have made my legs very strong. Core exercises have been outstanding as part of my total body conditioning routine as well. I am still doing these workouts one year later and I plan to keep it up. There is every reason to be fit before THR and after! I cherish my new mobility and I thank you for your candid message regarding maintaining a healthy weight and staying fit.