Which Are The Different Hip Replacement Approaches?

Which Are The Different Hip Replacement Approaches?

During a total hip replacement in Bangalore, an artificial hip is installed within the patient’s body. Such prosthesis could be made of a variety of materials, and could involve various approaches towards performing the surgery. These include posterior, anterior, lateral, antero-lateral, and greater trochanter osteotomy. Let us learn about each of them in detail.

Posterior approach

This approach allows the surgeon to access the hip joint from the back. In this type of surgery, the piriformis muscle and short external rotators are taken off the femur. This gives the surgeon easy access to the acetabulum, while preserving the gluteus medius and gluteus minimus muscles that are responsible for hip abduction when the leg moves outward.

Anterior approach

Contrary to the posterior approach, the anterior approach accesses the joint from the front. In this surgery, the surgeon can work between the muscles without detaching them from the femur. Thus, the posterior capsule and muscles are left uncut. This surgery is most preferred because keeping these muscles intact can prevent post-surgical dislocations. During this surgery, the patient is laid down on a special surgical tale that positions him such that the hip joint can be easily accessed from the front. It is very difficult to insert straight femoral components without injuring the abductor muscles, which is why surgeon use a curved femoral replacement in the anterior approach.

Lateral approach

In the lateral approach, the gluteus medius and gluteus minimus are elevated instead of being cut, in order to provide access to the joint. Then, the hip joint is dislocated, and the acetabular socket and femur are exposed for preparation and insertion of the prostheses.

Antero-lateral approach

This approach detaches about one-third of the gluteus medius from the bone, which is later re-attached back in place.

Greater trochanter osteotomy

In this kind of surgery, the greater trochanter at the upper end of the femus is cut, which greatly increases the exposure of the hip joint. The greater trochanter is then later re-attached with the help of special wires.

There are various other approaches being developed and used by surgeons today. In fact, there are certain approached used today wherein neither the anterior nor posterior capsules are cut, and the hip is also never dislocated! This kind of approach is similar to the posterior approach, only with the difference that the posterior capsule or short external rotator muscles are not cut. Other minimally invasive approaches are also used where surgeons reduce the size of incisions to as small as 2.5 inches, thus reducing blood loss, damage to muscles and tissues, and pain. Such approaches also speed the healing and recovery processes.

Some approaches are more commonly used and preferred over others due to certain reasons. But, it is the surgeon who decides the approach that he is supposed to use on his patient, depending upon the patient’s condition, lifestyle, and capacity to tolerate. So, whenever you are planning to go in for a total hip replacement in Bangalore, trust your surgeon and let him decide the surgery for you.