Direct Anterior Hip Replacement

Hip replacement surgery has been around for decades, and has helped many patients regain mobility and return to normal activity. Over the years, advances in techniques like direct anterior hip replacement have continued to improve results for patients.

Dr. John Coen is a board certified orthopedic surgeon with nearly 25 years of experience. Dr. Coen stays up to date on the latest research surrounding new orthopedic procedures, and adopts new techniques when the research proves a real benefit to his patients. Direct anterior hip replacement is one of the newer approaches for hip replacement, but it has been performed for over a decade with substantial research conducted on outcomes. Dr. Coen has offered this procedure for over 10 years, He has performed an estimated 2,000+ anterior hip replacements over the course of his career.

Benefits of Direct Anterior Hip Replacement

Traditionally, hip replacements are completed through a posterior approach, with an incision made at the back of the hip. It requires the surgeon to divide the gluteal muscles and detach tendons. Although the tendons are reattached during closure, recovery might be more painful for the patient.

In contrast, the incision for a direct anterior hip replacement is made at the front of the hip and is a more “muscle-friendly” approach. The muscles at the front of the hip still have to be retracted to access the joint, but they do not have to be detached. Patients lie on their backs for the procedure, which can be easier for anesthesia purposes, and also allows for intraoperative imaging.

Benefits of direct anterior hip replacement include:

• Potentially less pain in the initial phase of recovery
• More accurate implant positioning due to intraoperative imaging
• Ensuring limb length and cup positioning is correct
• Ability to progress in the initial recovery phase sooner than posterior approach hip replacement

Because of these benefits, Dr. Coen uses the direct anterior approach for almost all hip replacement procedures.

Direct Anterior Hip Replacement Procedure

A direct anterior hip replacement takes Dr. Coen about an hour to complete. The procedure is typically performed in an outpatient facility, allowing patients to return home the same day.

During the procedure, Dr. Coen will make an incision at the front of the hip and retract the muscles over the hip to access the joint. He will then remove the damaged bone and cartilage in the joint and replace these components with hip implants. Hip implants are typically comprised of a stemmed metal ball implant that is fitted into the upper end of the femur (thighbone) and a cup that is fitted into the hip socket. A plastic spacer is inserted between the metal components to allow the joint to glide smoothly.

Dr. Coen uses fluoroscopy (x-ray guidance) during hip replacement procedures to get better visualization of the joint to ensure accurate implant placement. He also checks limb length in relation to the patient’s other leg to ensure it is as even as possible.

Recovering from Direct Anterior Hip Replacement

With direct anterior hip replacement, patients tend to be able to progress more quickly in the initial recovery phase as compared to the posterior approach. Patients may experience some soreness from the muscle retraction, but this tends to be less painful than procedures in which muscles have to be detached or divided. Avoiding dislocation is less of a burden than posterior hip replacement. Patients may sleep on their sides, but should avoid sleeping on their stomach for the first 6 weeks after surgery.

Because direct anterior hip replacement tends to result in less pain and fewer concerns in the initial recovery period, patients may get back to normal activities and reach early recovery goals more quickly. Dr. Coen believes that physical therapy is an important part of the recovery process and recommends that patients work with a physical therapist for at least the first 4-6 weeks after surgery.

Full recovery from direct anterior hip replacement ultimately depends on how quickly patients reach the recovery goals set with the physical therapist. Every patient’s recovery goals are different, depending on what they do in their work and daily lives. The goal is to allow patients to do the activities they want without pain.

Direct Anterior Hip Replacement in Tualatin and Oregon City, OR

Dr. John Coen is a board certified orthopedic surgeon with nearly 25 years of experience. Dr. Coen carefully considers new procedure options based on research and only adopts new techniques that are proven to benefit patients. Dr. Coen believes that patients can benefit from direct anterior hip replacement, particularly in the initial recovery period, and has performed approximately 2,000 anterior hip replacements over the course of his career. If you would like to learn more about direct anterior hip replacement or schedule a consultation with Dr. Coen, please call our office at (503) 656-0836 or use the Appointment Request form.

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