Ask the Expert: Anterior Hip Replacement Surgery

8.20 Blog

In this week’s installment of Ask the Expert, Dr. Michael Alexiades, Orthopedic Surgeon, discusses the anterior approach to hip replacement surgery.

Anterior hip replacement surgery, where the surgeon accesses the hip from the front, is an alternative to other hip replacement surgery. The anterior procedure is sometimes called a mini hip replacement or mini anterior hip replacement because it uses an incision in front of the hip that can be as small as 3-4 inches rather than the traditional 8-12 inch incision used in traditional approaches. It’s also known as a muscle or tissue-sparing hip replacement because it doesn’t require detaching or cutting muscles or tendons.

The location in which the hip joint is accessed is what makes the anterior approach unique; as with other hip replacements, worn hip components are replaced with a metal socket lined by a metal, plastic, or ceramic insert, and a metal thighbone prosthesis connected to a metal or ceramic ball that rotates within that socket. You will be encouraged to bear weight on your hip almost immediately after surgery. There are few dislocations after anterior hip replacements, so unlike other procedures that usually require movement restrictions to prevent accidentally dislocating the hip while healing, you will be able to bend at the hip, cross your legs, and sleep without a pillow between your knees.

Most patients return home within two days of the procedure, but some leave the day after or even the same day as the procedure. Drain tubes, which I personally do not use, will be removed the day after surgery and the external stables or sutures are usually removed in 10 days to two weeks. My preference is for a plastic surgical closure with dissolving sutures that allows for showering within a few days after surgery. Your scar will fade considerably over time.

Because muscles are not cut or detached, there is often minimal pain during recovery and patients generally don’t need extensive physical therapy. Most patients use crutches for a day or two then a cane for about a week and are able to walk unaided and return to light physical activity in about two weeks. Your surgeon will recommend when you can return to specific sporting activities and driving.

The anterior approach can be used in most patients needing hip replacement. Exceptions are patients with extensive metal hardware due to prior surgery that may require removal and certain hip deformities. The anterior hip replacement procedure minimizes the impacts of recovery, provides complete or nearly complete pain relief for a wide variety of patients, and has a high degree of patient satisfaction.


Dr. Michael Alexiades
, Orthopedic Surgeon, concentrates on orthopedic surgery of the hip, knee, shoulder, and elbow, including arthroscopic surgery for each of these joints, joint-sparing surgery and joint replacement. He is an early adopter of the Mini Anterior technique in hip replacement surgery and has been active in the development of hip and knee implant design and instrumentation, including the Biomet Vision Hip system and Biomet knee systems.

The information provided in this blog by HSS and our affiliated physicians is for general informational and educational purposes, and should not be considered medical advice for any individual problem you may have. This information is not a substitute for the professional judgment of a qualified health care provider who is familiar with the unique facts about your condition and medical history. You should always consult your health care provider prior to starting any new treatment, or terminating or changing any ongoing treatment. Every post on this blog is the opinion of the author and may not reflect the official position of HSS. Please contact us if we can be helpful in answering any questions or to arrange for a visit or consult.

14 Comments

  1. I recently had anterior hip replacement surgery by an HSS trained surgeon. Great out come, minimal post op pain, only a 4″ incision, I was walking without a cane in a week and over all quick recovery. Now, 8 months later, I don’t even think about my hip replacement. If you are a candidate, anterior is best approach.

  2. Can this procedure be an option for hip replacement due to synovial osteochronomatosis? I had arthroscopy ten years ago to remove numerous loose bodies. hip replacement has been recommended. I am female, 55 years, have arthritis, and need knee surgery as well, unfortunately same side.

    1. Hi Terri, thank you for reaching out. Dr. Michael Alexiades, Orthopedic Surgeon, says: “Yes, this procedure can be an option for hip replacement due to synovial osteochronomatosis. If pain persists, you should seek a consultation with an orthopedic surgeon.” If you wish to receive care at HSS, please contact our Physician Referral Service at 877-606-1555 for further assistance.

    1. Hi Patricia, thank you for reaching out. Dr. Michael Alexiades, Orthopedic Surgeon, says: “For the anterior hip method, x-ray time lasts about 10 seconds.” If you wish to receive care at HSS, please contact our Physician Referral Service at 877-606-1555 for further assistance.

    1. Hi Carolyn, thank you for reaching out! Dr. Michael Alexiades, Orthopedic Surgeon, says: “Yes, typically I advise patients to take aspirin if they are at a low risk and Coumadin if they are at a high risk. Before taking any measure, I advise all patients to consult with their physician first.” If you wish to receive care at HSS, please contact our Physician Referral Service at 877-606-1555 for further assistance.

  3. my hip was replaced 18 years ago i have been in pain in my lower back on the same side since the surgery. the pain starts when i stand or walk or put weight on the leg.i have been told that the rod was coming loose and i would need surgery again.would you be able to help me? i also had the other side 17 years ago that one is fine. i have been to many drs. but none have been able to help me thank you

  4. Is a general anesthetic used or spinal. Also I was told if you have any sort of belly/belly fat or are short the surgeon could not access the hip from the front. Is this true?

    1. Hi Diane, thank you for reaching out. Dr. Michael Alexiades, Orthopedic Surgeon, says: “Usually, we use a spinal anesthetic. It is rare that it cannot be done for the conditions that you have listed, but it can prove to be more challenging for some surgeons.” If you wish to receive care at HSS, please contact our Physician Referral Service at 877-606-1555 for further assistance.

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