Anterior Total Hip Replacement

Puttering about with a walker for weeks… not being allowed to bend over to tie your shoes for months… if those are the recovery scenarios you imagine when you think of “hip replacement,” think again. As orthopedic surgeon, Dr. Daniel Mangiapani says, “It is rewarding to see the excitement on a patient’s face when I explain that after direct anterior hip replacement—you have no motion or weight bearing restrictions and will likely feel comfortable returning home the day after surgery.”

Dr. Mangiapani, who specializes in primary, complex, and revision hip and knee replacement surgeries, is one of a growing number of physicians who are looking at hip surgery from a new viewpoint – the anterior viewpoint, to be specific. Joining the ranks of cutting-edge surgeons around the U.S. and the world, Dr. Mangiapani specializes in a relatively new procedure known as “muscle-sparing direct anterior total hip replacement,” or “rapid recovery hip replacement,” as he calls it.

Traditionally, surgeons have performed total hip replacement (also known as “total hip arthroplasty,” or THA for short) by making a long incision on the side of the hip. In the direct anterior approach, Dr. Mangiapani makes a single small incision (approximately 3-4 inches long) on the front of the hip.

By taking this anterior approach, Dr. Mangiapani is able to perform the entire surgery without detaching any of the major muscles that have made recovery from hip replacement surgery so grueling in the past.

“With rapid recovery hip replacement,” he says, “we’re able to offer patients the possibility of a faster recovery with less pain, lower risk of dislocation, and greater mobility. Many patients who choose this option experience a rapid recovery and a shorter hospital stay.”

Potential benefits include:

• Faster recovery because muscles are not detached, which means patients have a greater range of motion and strength earlier on in the recovery process.
• No motion restriction following surgery. In recovering from other approaches, patients’ movements are often restricted to promote recovery and prevent dislocation.
• Lower risk of dislocation because muscle tissue is spared during the procedure.
• Reduced scarring due to less trauma to the operative area (compared to other approaches).
• Improved precision in placing components as a result of intra-operative x-ray technology.
   

While the direct anterior approach offers many benefits over traditional and minimally invasive THA, Dr. Mangiapani reminds patients that the choice of surgical approach should be individualized to each patient to meet their goals. “We take many factors into consideration when evaluating a patient’s eligibility for an anterior hip,” he says. “Age, activity level, and medical history all factor into the equation.”

For patients who do qualify, rapid hip surgery could potentially offer a significant advantage when it comes to recovery. For more information, contact Salt Lake Regional Medical Center below.