Hip Replacement - Boulder Joint Replacement Center

Surgical Approaches to the Hip

Traditional hip replacement surgery involves making an incision on the side of the hip (lateral approach) or the back of the hip (posterior approach). Both techniques involve detachment of muscles and tendons from the hip in order to replace the joint. The detachment of these muscles may result in increased pain after surgery and often prolongs the time to fully recover by months or even years. Failure of these muscles to heal after surgery may increase the risk of hip dislocation (the ball and socket separating), which is the leading cause of hip replacement failure. Hip precautions after surgery (no bending greater than 90 degrees, no crossing legs, no excessive rotation) are generally required for this reason.

Direct Superior Approach for Hip Replacement

The DS approach to the hip differs from the traditional posterior and mini-posterior approaches because it preserves the iliotibial band, quadratus femoris muscle, and obturator externus tendon1, potentially suppressing dislocation. The DS approach to the hip causes less soft-tissue destruction, especially to the gluteus minimus and tensor fasciae latae muscles, compared with the direct anterior approach to the hip, suggesting DS-THA may enhance postoperative mobility1,3,14-16. DS-THA is extensile by extending the incision distally, incising the iliotibial band, and releasing the quadratus femoris muscle. This converts a DS approach to a standard posterolateral approach, providing additional visualization.

Nancy’s Story: Choosing Avista for Hip Surgery

Nancy Carter isn’t a woman who slows down. She’s a wife, mother, grandmother, dog lover and life-long adventurer. So when hip pain started making everything she loved to do unbearable, she turned to Dr. Michael Wertz and Avista Adventist Hospital for hip replacement surgery. Watch Nancy’s story below to learn how the surgery, her orthopedic team and the care she received at Avista changed her life for the better. To learn more about Avista Adventist Hospital’s award-winning joint and spine care center, visit www.avistahospital.org/joint.

Direct Anterior Hip Approach

Direct anterior hip replacement is a minimally invasive surgical technique. This approach involves a 3 to 4 inch incision on the front of the hip that allows the joint to be replaced by moving muscles aside along their natural tissue planes, without detaching any tendons. This approach often results in quicker recovery, less pain, and more normal function after hip replacement. Because the tendons aren’t detached from the hip during direct anterior hip replacement, hip precautions are typically not necessary. This allows patients to return to normal daily activities shortly after surgery with a reduced risk of dislocation.

Total Hip Replacement

Hip pain, stiffness, and limited range of motion can keep you from your daily activities. When this occurs, you may need a hip replacement. For patients with arthritis (which is the most common source of debilitating hip pain), the goal of hip replacement is to restore function, mobility, and decrease pain. Hip replacement surgery is one of the most successful operations in all of medicine.

The hip is a ball and socket joint. Normally, the cartilage coating over the bones makes the joint move smoothly and provides an additional shock-absorbent cushion. Arthritis occurs when the cartilage surface wears out and you begin rubbing bone on bone. This can cause pain, decreased motion, and stiffness to the hip joint.

If conservative treatment methods have not relieved your hip pain or allowed you to continue with daily activities, your doctor may recommend surgery. Total hip replacement surgery involves the removal of the arthritic surfaces of the hip joint and replaces them with implants. The implants are designed to replicate the hip joint and are made of metal, plastic, and/or ceramic. This allows the joint to move smoothly again.

Joint replacement is a major decision. Our goal is to provide you with as much information as possible to choose the right procedure for you. Our surgeons stay current with advances in anesthesia, surgical techniques, and technology to offer you the best surgical experience possible.