Anterior hip replacement
A muscle-sparing way to replace the hip joint, reached through the front of the upper thigh. This guide explains how the operation works, who it suits, and what recovery looks like.
- Approach
- Front of the hip (anterior)
- Anaesthetic
- Spinal or general
- Hospital stay
- Often same day or one night
- On your feet
- Usually the day of surgery
- Operative time
- A little longer than other approaches
What it is
In a total hip replacement, the worn ball and socket of the hip are replaced with smooth implant surfaces. The direct anterior approach reaches the joint through the front of the upper thigh.
The surgeon works in the natural gap between muscles and moves them aside rather than cutting them. Because the muscles that support the hip stay attached, many people find the first few weeks more comfortable and steadier on their feet.
Dr. Khoshbin performs the anterior approach on a specialised table that holds the leg in position and allows the leg length and the placement of the implants to be checked during the operation.
No single approach is best for everyone
Compared with other approaches, the anterior approach tends to offer less pain and a quicker return to walking in the first two to four weeks. After that early period the approaches reach a similar place, and no study has shown one approach to give a better result in the long run. The right approach is the one that fits your anatomy, your health, and the complexity of your hip.
Who it suits
The anterior approach suits many people having a first-time hip replacement. It can be a less suitable choice when the hip has had earlier surgery with hardware in place, when the pelvis is shaped in a way that makes the front of the joint harder to reach, or at a higher body weight, where a front-of-hip wound can heal more slowly.
Dr. Khoshbin reviews your history, your imaging, and your body type together, and recommends the approach he expects to give you the safest, most reliable result. If a different approach suits you better, he will explain why.
How to prepare
- Build strength beforehand. Gentle exercise for the hip and legs in the weeks before surgery helps your recovery.
- Set up your home. Clear your walking paths, remove loose rugs, and put everyday items within easy reach.
- Sort out a walking aid. A cane or walker will help for the first few weeks.
- Review your medicines. Tell the team about blood thinners and supplements. Some need to be paused before surgery.
- Stop smoking if you can. It lowers the risk of wound and healing problems.
- Plan a ride home and some help. Arrange support for the first days back.
What to expect
- You have a spinal or general anaesthetic, so you feel nothing during the operation.
- The surgeon reaches the joint through one cut at the front of the upper thigh.
- The worn surfaces are replaced, and leg length and implant position are checked before closing.
- The operation usually takes a little longer than other approaches.
- Most people stand and take a few steps with a walking aid the same day or the next.
- Many go home the same day or after one night.
- You can usually bend and sit normally, without the movement limits some other approaches need.
- Mild bruising and swelling at the front of the thigh are common and settle over a few weeks.
A typical timeline
These are typical timelines and vary from person to person.
What the approach offers
The main advantages of the anterior approach show up early:
- Less pain and less limping in the first weeks for many people.
- Walking without a cane sooner, on average.
- Fewer movement restrictions afterwards, because the supporting muscles stay attached.
These early advantages are real, and they matter most in the first month. They do not mean the final result is better than other well-performed approaches. Long-term hip function, implant position, and how long the implant lasts depend more on the surgery being done well than on the approach used.
Risks to weigh
Every hip replacement carries some risk, and the anterior approach has a few of its own.
- A numb or tingling patch on the outer thigh. A small nerve near the front of the hip can be irritated, leaving a patch of altered feeling. It is usually minor and often improves with time.
- A longer operation and some X-ray use. The approach takes a little longer and uses brief X-ray during surgery to check position.
- Slower front-of-thigh wound healing in some people, more likely at a higher body weight.
- The general risks of any hip replacement, including infection, blood clots, a difference in leg length, dislocation, and a small chance of a fracture around the implant.
Dr. Khoshbin will go through the risks that apply to you before you decide on surgery.
When to call for help
Recovery has its ups and downs, and some signs need prompt attention. Contact your surgical team, your family doctor, or urgent care if you notice any of the following.
Your follow-up
You will be given a follow-up plan, usually with a check a few weeks after surgery and again later in the year. Your team will guide when to step up your activity. If something does not feel right between visits, it is always fine to ask.
The hospital's guide
St. Michael's Hospital also has its own patient guide to hip replacement surgery, covering preparation, the hospital stay, and recovery. Open the hospital's hip replacement guide (PDF).
This guide is general information about anterior hip replacement, written for patients of Dr. Khoshbin's practice. It is not a substitute for personal medical advice. Your own plan, timelines, and risks depend on your health and your surgery, and your surgical team's advice comes first.