Date: 2018. 08. 08.
There are a lot of debates about the advantages and disadvantages of the different approaches during hip replacement surgery. The aim of the hip replacement surgery is to ensure the free movement of the hips without pain for 10-15 years, thus improving the life quality of the patient. In our article we compare the anterior, the posterior and the lateral approaches.
Those who prefer the anterior approach say that the recovery after the surgery is faster, the patient can leave the hospital sooner and can get back to their everyday life earlier. With this approach the visibility is not so good: technically it’s harder to do surgery on a patient with more muscle or who is overweight and the possibility of bone breaking during the surgery is higher if the patient has osteoporosis. Often a special surgical table is necessary to perform the surgery with posterior approach and to allow to position the limbs of the patient. According to some studies, during hipreplacement surgery with an anterior approach bleeding happens more often, thus the danger of the patient needing blood transfusion after the surgery is higher. The injury of a skin nerve can occur too.
The posterior approach is mostly used in the western countries, because it makes easier to approach the hip joint, therefore making every anatomial detail visible even for the assisting surgeon. Furthermore, using this approach the main muscles aren’t getting injured, and fast recovery is also possible. Almost anyone can be operated with this technique, even if the patient has more muscle, or is overweight or has osteoporosis. This approach has outstanding results regarding patient safety for decades.
In Hungary most hip replacement surgeries are done with lateral approach. During the surgery the muscle group (gluteus) that stabilises the hip during walking from the joint is detached. The average recovery time is the longest for this approach.
It’s important to know that after 6 weeks, the differences disappear between the different approaches.
Which approach is used the most?
A few years ago a research was made with the participation of 57 countries. According to the results, 45% of the orthopaedic surgeons use the posterior approach, while 42% of them prefer the lateral approach during a hip replacement surgery. 10% use the anterior approach, 3% an other one. In North America (USA, Canada) surgeons prefer the posterior approach, in Europe the posterior approach is preferred mostly in England and the Scandinavian countries. In Middle and Central Europe the lateral approach is the most common method.
Every approach has its advantages and disadvantages. Based on the evidences the researches show that every approach is suitable to ensure a safe hip replacement with outstanding long time results. Several prestigious articles and work group agree that the key to the patient have a functioning, painless hip joint after the replacement surgery is not the approach, but the technic, experience of the surgeon and the useage of the so called accelareted rehabilitation protocolls.
The solution: choose your orthopaedic surgeon!
We encourage every patient to ask questions, get know their doctors, hospitals!
Out of Duna Medical Center’s orthopaedic surgeons, Dr. Zsolt Hegedűs head doctor, hip specialist uses the posterior approach during hip replacement surgeries. He also does operations in the United Kingdom, where the success of hip replacement surgeries are closely monitored, therefore we can share statistics regarding his results.
During the more than 2000 hip replacement surgeries he performed
What to expect after the surgery?
We at Duna Medical Center perform surgeries with the posterior approach, which helps to lessen the time spent with rehabilitation. Our patients usually spend 3 days in the hospital after the surgery, while our physicotherapist helps them to walk safely by themselves.
Thanks to the posterior approach, and the so called local anaesthetic infiltration for pain relief and blood alleviation it’s really rare that our patients need blood supplement after surgery (less than 1%), furthermore, our patients can start physicotherapy 30 minutes after surgery, can stand up and walk a few steps.
Most of our patients have only mild pain after surgery and lot of them don’t take painkillers when discharged.
If you want to learn more about the technic we use during surgery, or would like to have a consultation, book and appointment by clicking here! Learn more about our orthopaedic surgeon: