Direct Anterior Approach
to Hip Replacement Surgery

Finding out you need hip replacement surgery can be scary, and choosing the correct surgeon who has the best skills is important for your peace of mind. Dr. Rieser of Shenandoah Valley Orthopedics uses the direct anterior approach to hip replacement surgery, a specialized approach designed to minimize recovery time for his patients. Traditionally, surgeons have approached hip replacement surgery from either the side (lateral) or back (posterior) of the hip. The traditional approach usually requires an incision up to 12 inches long and may disturb muscles, joint and connecting tissues. Both of these options affect the length, pain level and success of healing post surgery. The direct anterior approach to hip replacement surgery minimizes the invasive impact on the patient. Dr. Rieser approaches from the anterior, or front, of the hip. The surgeon generally requires only 4 to 6 inch incision as opposed to the longer, traditional incision. This access point allows the surgeon to circumvent muscle. By avoiding the muscles in the front and side of the joint, Dr. Rieser can avoid potentially damaging those muscles and nerves, which speeds healing in his patients. The direct anterior approach to hip replacement is a highly specialized surgery that requires additional training and practical skills. Dr. Rieser is one of a very few orthopedic surgeons who has the practical training and skill level required to successfully implement the approach for a patient. Advantages of the Direct Anterior Approach Small Incision The traditional lateral and posterior incisions can be as long as 12 inches. The anterior approach most often sees incision sizes of 4 to 6 inches. A smaller incision generally means a smaller, less noticeable scar. It also requires a shorter healing time and is often easier to care for post surgery, which reduces the risk of post surgical infections. Minimize Disturbance of Tissues When surgeons enter the hip from the front or back, they must split the gluteus maximus muscle and also detach and reattach two of the external rotator muscles. Detaching and reattaching muscles means a longer healing time for the patient, with the risk of nerve damage in the surrounding tissues. Although the anterior approach may disturb the connective tissues of the hip, this approach minimizes the surgical impact on the muscles and connective tissues. With an anterior approach, only the piriformis muscle (the muscle that runs from the lower spine to the upper surface of the femur bone) is detached in order to make way for the femoral implant. It is then reattached with minimal impact to the muscle. Faster Healing Time Dr. Rieser can’t guarantee healing time with his direct anterior approach, as that depends on age, health, patient compliance and overall success of the surgery. However, hip surgery via the direct anterior approach generally requires between 1 and 3 months of recovery, while the more traditional approaches require 3 or more months. The direct anterior approach shortens the time needed before a patient is able to sit and stand by at least a week, and shortens the time required for full activity by at least a month. This faster recovery time allows Dr. Rieser’s patients to return to the activities they love faster and with less pain than if they choose the more traditional approaches to hip replacement surgery. To learn more about the direct anterior approach to hip replacement surgery, or to schedule a consultation with Dr. Rieser, call us at (540)932-5850.