Posterior vs Anterior Hip Replacement: 7 Key Differences

Key Takeaways

• Hip replacement is the surgical process of replacing the hip joint with a prosthetic implant to restore function by minimizing pain and increasing mobility. This surgery can be performed as a total or partial hip replacement.
• The main difference between posterior and anterior hip replacements is the incision location; posterior hip replacements enter from the back or side of the hip, while anterior hip replacements enter from the front.
• Deciding between posterior and anterior hip replacements can determine if and how muscles are cut, the accessibility of the hip joint, dislocation risk, recovery time, scarring potential, and required postoperative precautions.
• When deciding which hip replacement to opt for, the patient should consider their medical history, the condition of their hip, surgeon recommendations, personal preferences, and how long-term outcomes may affect their lifestyle.

Understanding the Differences Between Posterior and Anterior Hip Replacements

Some people require hip replacement surgery to relieve pain and restore function to one of their most important joints. This procedure involves replacing a broken or arthritic hip joint with an artificial implant. Usually, the damaged portions of the hip joint are removed before being swapped out with a prosthetic replacement.

Approximately 544,000 hip replacements are performed annually in the United States; however, not every surgery follows the same approach. Depending on the portion of the hip that is damaged, many patients can benefit more from an anterior hip replacement vs posterior, meaning the incisions are made in the front rather than the back or side of the hip.

The considerations below can help you understand the differences between posterior vs anterior hip replacements and make informed decisions that encourage quick and smooth recovery. Consulting a qualified joint specialist is an excellent way to determine which hip replacement surgery, anterior vs posterior, is best for you.

Hip Replacement Surgery Overview

Hip replacement involves surgically replacing the hip joint with a prosthetic implant. Depending on the patient’s needs, this type of surgery allows for total and partial hip replacements.

Reasons for Hip Replacement Surgery

Hip replacements can be a beneficial solution to various medical problems. Some examples of reasons someone might get hip replacement surgery are:

• They have severe osteoarthritis in their hip.
• Their joint has been damaged by rheumatoid arthritis.
• They have a bone fracture within their hip region.
• There are tumors in their hip due to bone cancer.
• Their hip bone is deprived of blood and dying from avascular necrosis.
• There is a problem with their implant from a previous hip surgery.

Hip replacement surgery aims to help patients regain mobility, reduce pain, and facilitate day-to-day activities. So, after healing from their surgery, some of the aforementioned medical problems may be alleviated.

What to Expect During the Procedure

Hip surgery can look slightly different for each patient due to the uniqueness of their hip condition and the surgeon’s expertise or preferences. Nevertheless, you should educate yourself on the general procedure and other important things to know before your hip replacement surgery.

Some examples of steps that may be included in your hip replacement surgery are:

• Consultations and scheduling meetings to plan your surgery.
• Being sedated by an anesthesiologist on the day of your surgery.
• While sedated, the surgeon makes an incision to access the hip joint.
• The surgeon removes diseased bone or cartilage through the incision.
• The surgeon installs a prosthetic like a metal or ceramic ball and socket.
• The incision is sealed, and the patient is slowly brought awake.

You may be able to go home shortly after your surgery is complete; however, your healing process will be closely examined over the next handful of months.

Recovery Expectations

Hip replacement surgery recovery timelines vary between patients. Nevertheless, many patients may experience discomfort and swelling right after surgery; these symptoms can be controlled with medicine and physical therapy.

Early recovery may implement guided workouts to rebuild strength and mobility. If they take post-surgery precautions, many patients can walk with assistance after just a few days of healing. Still, progressively returning to their regular activities can take a few months.

Although patients may have to adjust their lifestyles, full recovery is usually achieved within six months to a year after the surgery. Routine follow-up appointments, post-surgery symptom monitoring, and adherence to rehabilitation guidelines are essential to promoting joint function and achieving the best possible outcome.

Posterior Hip Replacement

Some joint specialists use the posterior approach to hip replacement, meaning they make a curved incision from the back or side of the hip, just behind the femur’s trochanter, before removing and replacing the damaged joint with a prosthetic one.

Advantages of Posterior Hip Replacement

Posterior hip replacement provides clear, direct access to the hip joint. For this reason, the posterior approach has been used for several decades before technology increased the feasibility of anterior hip replacements. Additionally, the posterior approach is versatile, making it easy to perform more extensive procedures like correcting bone deformities.

Potential Drawbacks of Posterior Hip Replacement

Posterior hip replacement may include cutting through major muscles and tendons, potentially resulting in extended recovery periods and weakened muscles. Compared to anterior hip replacement, the posterior approach cuts a larger area, meaning the risk of infection is slightly higher.

Changes to the Recovery Process

During recovery, patients may need to follow more stringent movement guidelines to prevent dislocation and promote appropriate healing because the posterior approach affects more muscle groups than its anterior counterpart. Nevertheless, many patients can see significant mobility and pain improvement within a few months after surgery.

Anterior Hip Replacement

Anterior hip replacement involves making an incision in the front of the hip instead of the back or side. This approach allows the surgeon to push the muscles aside and work between them to reach the hip joint. This natural separation allows the hip joint to be easily accessed with minimal muscle cutting required.

Advantages of Anterior Hip Replacement

Patients may experience various benefits by opting for anterior hip replacement. Some examples of advantages that the anterior approach can offer are:

• There is less cutting of the muscles surrounding the joint’s back.
• Potential for a faster recovery due to less muscle damage.
• Presents a low risk of post-surgery dislocation thanks to muscular support.

Anterior hip replacements are widely preferred over posterior hip replacements because of their positive impact on recovery.

Potential Drawbacks of Anterior Hip Replacement

For a while, anterior hip replacements have been considered challenging because they require high technical complexity to avoid nerve damage. They have only grown in popularity recently because of advancements in technology like Mako SmartRobotics and education, which make performing this surgery easier.

Still, the anterior approach provides limited access to the hip joint, minimizing visibility, making this approach better for experienced joint specialists like the ones at the Joint Replacement Center of Scottsdale. Nevertheless, anterior hip replacement is unsuitable for some patients, especially those with unique anatomical challenges or needing extensive reconstruction.

Changes to the Recovery Process

Thanks to the minimally invasive nature of anterior hip replacements, many patients can resume their daily activities sooner than with the posterior approach. Patients typically start walking with minimal assistance within a couple of days. Nevertheless, pain management and physical therapy are still crucial for early recovery.

Many patients recover fully in about six months if they closely follow postoperative guidelines and make necessary lifestyle adjustments. Talk to a qualified healthcare professional to see if this approach fits your medical needs.

Key Differences Between Posterior and Anterior Hip Replacement

Educating yourself on what separates posterior and anterior hip replacement from one another is crucial. The following seven considerations cover some of the most notable differences between these two types of hip replacement surgery.

1. Incision Location

For a posterior hip replacement, the incision is made on the back or side of the hip. During an anterior hip replacement, the incision is made on the front of the hip.

Moreover, an anterior hip replacement requires a smaller incision, roughly 4” to 6”, compared to the 10” to 12” incision needed for the posterior approach.

2. Muscle Cutting

Posterior hip replacements usually require cutting the tensor fascia lata, the broad area of soft, fibrous tissue near the top of the outer thigh that assists in stabilizing the hip and knee. The surgeon may also have to cut the large gluteus maximus muscle that is used for extending and rotating the thigh outward. Sometimes, the external rotators of the hip, small short muscles that provide hip stability, are also severed.

Because it requires cutting major anatomical structures, the posterior approach can result in long recovery periods with limited mobility. Alternatively, anterior hip replacement spreads most hip muscles apart rather than cutting them, preserving more muscle tissue and facilitating recovery.

3. Recovery Time

Due to the size and muscle incisions, posterior hip replacement generally involves more extended recovery periods and movement restrictions. Anterior hip replacement often allows for a quicker recovery and fewer postoperative restrictions.

4. Dislocation Risk

Generally, posterior hip replacement presents a higher risk of hip dislocation due to the lack of muscle integrity. On the other hand, anterior hip replacement can minimize dislocations by preserving the muscle structure around the hip.

5. Postoperative Precautions

Usually, anterior hip replacement requires few movement restrictions after the surgery is complete because the surgical process is not as intrusive. However, a posterior hip replacement will likely require specific precautions to prevent dislocation, such as avoiding certain bending movements or sitting positions.

6. Visibility & Access

Most times, posterior hip replacements offer better visibility and access to the hip joint, which can be beneficial in complex cases that require significant alterations. Anterior hip replacements require more intricate surgical work because they provide less visibility and access to the joint.

7. Scarring

Scarring is based on the incision site, so posterior hip replacements will usually leave a scar on the back or side of the hip, while the anterior approach may leave scarring on the front of the hip, which can be more noticeable.

Understanding the differences listed above is essential to make informed medical decisions.

Factors to Consider When Choosing Between Posterior and Anterior Hip Replacement

Before deciding which hip replacement approach to get, you and your healthcare provider should thoroughly discuss the procedures. Some examples of factors that you and a medical professional may discuss are:

• Your medical history
• The condition affecting your hip
• What the surgeon recommends
• The skill of the surgeon performing your surgery
• The tools the surgeon plans to use
• Possible effects on recovery
• Long-term results of both types of hip replacement
• Lifestyle factors
• Your personal preferences

Ultimately, the decision will be up to you and the medical professional performing the surgery. However, discussing the above factors can help you understand why a particular approach is better.

Find Long-Term Relief From Hip Pain

To know which hip replacement surgery, anterior vs posterior, you should get, you should rely on the knowledge of a medical professional and consider the lasting implications of each surgery. For example, the front of your pelvic region may exhibit scarring after an anterior hip replacement vs posterior, which leaves scarring on the back.

Many people opt for the anterior approach because it can offer reduced recovery times, mitigated dislocation risk, and less muscle damage. Nevertheless, you should consult a qualified medical professional to debate posterior vs anterior hip replacements as a solution for your unique condition.

The Joint Replacement Center of Scottsdale has substantial experience performing anterior total hip replacement and revision surgery. Our highly qualified joint specialists practice minimally invasive surgical techniques using top-of-the-line technology like Mako SmartRobotics, which can facilitate recovery and help patients get back to day-to-day activities as soon as possible.

Schedule a consultation to develop a customized treatment plan for your unique hip complications.