The Anterior Total Hip Walkthrough – What Happens in Surgery

Aug 30, 2019

Richard “Alex” Sweet II, MD

The Operative Set Up:
The Hana Table is a specialized surgical table designed specifically for the anterior hip approach. It allows the surgeon to safely perform the surgery and helps to minimize complications.

1. The hip is exposed by splitting the space between two muscles, allowing me to perform the surgery without cutting any muscle. The anterior approach is the only approach that is truly muscle sparing. This helps with pain control as well as faster mobilization and recovery after surgery.

2. Next the femoral neck is cut with a saw and the arthritic femoral head (ball of the ball and socket joint) is removed.


3. Then the acetabulum (socket part of the ball and socket joint) is prepared. The arthritic acetabulum undergoes a procedure called reaming. The reamer is a hemispherical shaped tool that rotates and cuts away bone and cartilage. Reamers of increasing diameter help to shape the bone so that the acetabular prosthesis (cup) will fit.


4. The cup component is then inserted with the use of X-ray to ensure proper align-ment. Screws may or may not be used to secure the cup and then the plastic liner is inserted into the cup.


5. Next the femur is exposed by externally rotating the leg, and dropping the foot to the floor. This movement is safely facilitated by use of the Hana table and is the signature move of the anterior approach. Broaches are then used to size the femur, with larger broaches being inserted until the correct size is established.


6. The hip is then tested or “trialed” with several different size components. I select the best size to re-create your anatomy and establish a stable total hip joint. This is verified by both testing the leg physically, and by x-ray evaluation. Finally after the proper sized trial implants have been selected, the hip is dislocated, all trials are removed, and the real femoral component and ball are inserted


7. Your incision is closed in several layers, adding to hip stability and the cosmetic appearance of the wound.

What our patients are saying
Shaun H.
I was able to get a office visit on short notice. It seemed to be a very busy day. Rebecca took the time to listen to all of my issues and discuss a plan for additional treatment. I have always been impressed with her knowledge and bed side manner.
Reviews from Google
Joanna S.
Dr Goodin has replaced both of my knees this year with excellent results. He and Carly listen to my concerns, act promptly and work hard to make this journey the best it can be. Carly and Dr Goodin both have GREAT bedside manner and I feel I am in expert care with them.
Reviews from Facebook
Carolyn K.
Dr. Yakkanti did my knee replacement in June. He is an excellent surgeon with a great bedside manner. I have recovered nicely and plan to have my other knee replaced within the next year. I would highly recommend Dr. Yakkanti to anyone thinking about knee replacement!
Reviews from Facebook
Juanita S.
The New Albany office of Louisville Orthopedic is full of terrific people who know what excellent customer service is about! From the front desk to the lab, they are great. Doctor Lewis is my surgeon and I love him. He’s good at what he does and he’s compassionate. I would recommend him to anyone.
Reviews from Facebook
Erin Z.
This was my first time at Louisville Orthopaedic Clinic and I saw Melissa Parshall PA-C. I was very impressed with how fast I got in, had x-rays, and met with her. She was very thorough and extremely friendly. So glad A friend told me to come see you guys! Thank you!
Reviews from Facebook
See All Reviews
Louisville Orthopaedic Clinic

4130 Dutchman's Lane,
Suite 300,Louisville 40207
(502) 897-1794

Louisville Orthopaedic Clinic

1425 State St.,
,New Albany 47150
(812) 920-0408

Louisville Orthopaedic Clinic
4130 Dutchman's Lane
Suite 300
Louisville, KY 40207

Louisville Orthopaedic Clinic
1425 State St.
New Albany, IN 47150