What Is An “Anterior” Total Hip Replacement
An anterior total hip replacement is also known as a total hip arthroplasty and is a surgical procedure that replaces a damaged hip joint to allow patients to function without hip pain. Anterior refers to where Dr. Martin places his incision, which is on the front of the thigh/ groin area. Both anterior and posterior hip (ie traditional hips) have excellent outcomes however the anterior approach allows patients to bounce back quicker. The surgery is often performed in an outpatient setting with patients up and walking within 1-2 hours of surgery. Improved patient recovery with the anterior approach stems from several different factors including:
- The muscle-sparing technique
- A quicker return to a full range of motion
- A decreased risk of dislocation
- The decreased pain after surgery
- Return to walking and moving quickly
What To Expect After Anterior Hip Replacement
After having an anterior total hip replacement you can expect the following:
- Procedure and Post Procedure
- Outpatient robotic hip surgery ranges from 60-90 minutes and once patients are stable they can go home
- Going Home
- Patients will go home with a walker for balance and are up walking within a few hours of surgery
- Patients can shower the same day as surgery
- Physical Therapy
- Patients often do not require formal physical therapy after an anterior hip replacement
- Walking after your hip replacement is the best therapy for patients, which is why they begin walking within an hour of surgery
Anterior Hip Replacement Recovery Timeline
Day Of Surgery
- The procedure itself ranges from 60 to 90 minutes
- Each patient is unique and anesthesia depends on a patient’s health status but Dr. Martin prefers to use spinal anesthesia for his patients
- Spinal anesthesia allows a patient’s lungs and upper body to keep working during surgery, lower blood pressure, and reduces post-operative pain.
- Dr. Martin also utilizes an analgesic medication inside of the surgical incision to control post-op pain.
- After the surgery is complete patients are awoken in the post-operative recovery area where it can take 30-60 minutes to fully wake from the medications
- After the anesthesia has worn off, they are allowed to get up and walk with the aid of a walker for balance purposes
- The incision is closed with absorbable sutures and skin glue. There is no dressing to care for
- After patients have walked well with the walker, used the restroom, and feel confident moving they are discharged home
- Patients are provided a hand out with exercises to begin and movements/motions to avoid called anterior hip precautions.
- There are no diet restrictions after surgery, but we do recommend starting with a small meal and plenty of liquids
- All medications patients need in the postoperative period will be sent directly to the pharmacy for pick up.
- Pain management medication varies from patient to patient and will be discussed with Dr. Martin
- For blood thinning after the surgery, Dr. Martin prescribes 81mg aspirin taken twice a day for 4 weeks.
- The facility will provide a walker to patients who do not have one at home
- Having the path from your door to the bedroom or couch is ideal prior to returning home
- Make sure pets and other tripping hazards are kept out of the way of the walker ( including cords and rugs)
- Patients may shower the same day as surgery if they desire
- After the surgery patients find it comfortable to sleep on their backs or on the non-surgical side, with a pillow between the knees. We do not recommend sleeping on the stomach.
1-2 Days After
- The first 1-2 days after surgery the medication Dr. Martin placed in the incision is still helping control pain. Patients typically feel very good.
- Patients are up walking (with the walker for balance) and starting to resume activities of daily living, such as showering, getting the mail, and walking through the house.
- A list of basic exercises to start will be in the discharge paperwork, patients typically start 1-2 days after surgery.
- Often patients are feeling very good and we advise during this time frame to not be too aggressive with activities.
- Pain medications may or may not be needed during this time frame and is wholly patient dependent.
- Patients may continue showering regularly but cannot soak in a bathtub, hot tub, or pool until evaluated in the office.
- The incisions should be monitored for any bleeding or drainage, but no other care is required. DO NOT SCRUB THE INCISIONS.
- There may be swelling, bruising, warmth, redness, tingling or numbness around the incision.
3 Days After
- On day 3 typically all of the pain-alleviating effects of the local medications have worn off. Patients may require pain medication this day/evening to rest comfortably. Use as prescribed.
- Swelling, redness, warmth, and tingling/numbness may still be felt around the incision site.
- Thigh stiffness and mild knee pain may be present.
- Patients continue their home exercises, daily walking, and medication regime.
- The use of the walker in the house is dependent on stability, but Dr. Martin recommends continued use of the walker in public until follow up.
5-7 Days After
- Patients will follow up in the office with Dr. Martin and his staff at around 5-7 days out of surgery.
- At this visit, Dr. Martin will address your medication management, incision healing, driving, work status and asses your gait and strength. This will determine whether or not he recommends formal physical therapy.
- At this time patients can start using a recumbent exercise bicycle or elliptical to begin building strength and stamina.
- Weaning off of the walker in public is common at this time, but is patient dependent.
- At the week mark patients may begin walking in the water ( pool or hot tub)
- Patients often begin weaning off of any narcotic pain medications at this time, but it is normal to require it for sleep for an extended period of time.
- Some patients resume driving at this time but it is largely determined by which hip was operated on.
- Patients return to the office for a 2 week follow up where Dr. Martin evaluates the patient’s scar, gait, and overall progress from the surgery.
- The skin glue at this time is typically in the process of falling off on its own but can require some light washing with a clean washrag.
- Patients begin to advance their activity levels and have weaned off of the walker in public at this time.
- Resuming non-impact activities such as chipping and putting can be expected.
- Anterior hip precautions fall away
- Patients begin to resume more heavy impact activities with guidance from Dr. Martin
- Patients notice the swelling and stiffness associated with the surgery begin to dissipate.
- Patients are back to work and normal activities.
- Dr. Martin recommends maintaining a home exercise program to continue strengthening the joint.
- Patients are discharged from the office and only follow up on an as-needed basis.
Common Anterior Hip Replacement Recovery Questions
When Can I Use The Stairs
- As soon as you feel comfortable and stable
When Can I Drive Again
- Driving depends on which hip had surgery and your individual use of pain medications but often patients start driving after 1-2 weeks
When Can I Resume Sexual Activity
- Sexual activity can be resumed at your comfort so long as anterior hip precautions are abided by ( no deep lunging or extreme hip extension)
When Can I Return To Work
- It all depends on what you do for work, patients with sedentary jobs can return as early as 1 week, others with high impact jobs may require 4-6 weeks.
When Can I Start Exercising
- Walking starts day 1
- Non-impact exercises like the exercise bike, swimming, and elliptical can be started within 1 week of surgery
- Heavy impact exercises like tennis and weight lifting can be resumed after 6 weeks
When Can I Travel On An Airplane?
- 2-4 weeks after a hip replacement with restrictions. Please speak to the office about air travel recommendations as it can vary from patient to patient
Will I require antibiotics for dental cleanings or dental work?
- Dental work poses a risk for infection close to surgery so it is recommended you wait 4 weeks after surgery prior to any dental work. Additionally, for 3 months from the date of surgery, Dr. Martin recommends an antibiotic for any dental work. After this time period, the dentists or treating specialist will decide.