The Anterior Total Hip Walkthrough – What Happens in Surgery

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.