One approach to performing THR is the Direct Anterior Approach, which involves accessing the hip joint from the front of the body. In this method, a surgeon makes an incision in the front of the hip to reach the joint directly, providing several potential benefits.
The Direct Anterior Approach to THR offers advantages over traditional posterior or lateral approaches. One significant advantage is the preservation of important muscles and tendons. By accessing the hip joint from the front, the surgeon can work between muscle groups rather than cutting through them. This preservation of muscle integrity can lead to a quicker recovery and less postoperative pain, as well as a reduced risk of dislocation. Additionally, the direct approach allows for better visualisation of the joint and accurate placement of the prosthesis, which can contribute to improved long-term outcomes.
The procedure begins with the patient lying on their back on a specialised operating table. The surgeon identifies the precise location for the incision, typically a few inches in length, near the front of the hip joint. Once the incision is made, the surgeon carefully separates the muscles and tendons to access the hip joint. Unlike other approaches, the Direct Anterior Approach does not require detaching any muscles from the pelvis or femur bone.
After gaining access to the joint, the surgeon removes the damaged portions of the hip socket (acetabulum) and femoral head, preparing them to receive the artificial components of the prosthesis. The acetabular component, typically made of metal, plastic, or ceramic, is secured into the socket using screws or cement. The surgeon then replaces the femoral head with a metal stem that is inserted into the femur bone. A ceramic or metal ball is attached to the stem, which will articulate with the acetabular component to form the new hip joint.
Once the components are securely in place, the surgeon tests the range of motion and stability of the new joint to ensure proper alignment. The muscles and tendons are then carefully repaired and closed, and the incision is typically closed with sutures or staples. A sterile dressing is applied to the wound, and the patient is transferred to a recovery area.
The recovery process following a Direct Anterior Approach THR is often faster compared to other approaches. Patients may experience less pain, reduced hospital stays, and faster return to daily activities. However, it is crucial to follow the postoperative instructions provided by the surgeon, which may include physical therapy exercises, medication management, and restrictions on certain activities to aid in healing and rehabilitation.