Anterior Hip Replacement
I have adopted the direct anterior approach for hip replacement for essentially all of my patients in recent years. Dr. Bonner and I are the only surgeons at the Institute either currently performing, or to have ever performed, this minimally invasive surgical approach. I spent the prior years evaluating the development of the technique through research and patient outcomes. I trained with Dr. Joel Matta (developing surgeon) at his courses, and was fortunate to be selected by him to join the Anterior Hip Foundation and be the first to be trained through their program. I have subsequently spoken as faculty at the annual Anterior Hip Foundation meeting since 2017, and proudly served as President of AHF in 2022-23.
The anterior approach has potential advantages over other approaches of not cutting muscle, going between natural muscles planes, improving recovery, eliminating hip precautions, and providing a more stable hip joint.
- muscle-sparing approach, goes between natural muscle planes
- subsequently no hip precautions, faster recovery
- only approach able to use live x-ray during surgery which optimizes:
- implant sizes to fit patient uniquely
- component position for best alignment in bone
- leg length equality, because xray allows comparison to opposite hip during surgery
- specialized OR table assists patient positioning during surgery (see video below)
These advantages are unique to the anterior approach, compared to other traditional techniques. Because of this, the direct anterior approach continues to increase nationally in utilization, surpassing 50% of all procedures and still growing. Recent research increasingly supports the benefits of this approach, and my own clinical experience with the technique has shown benefits and advantages over my already rapid recovery less-invasive mini-posterior approach.
Since 2019, over 50% of hip replacements in the nation are performed via the anterior approach, and continues to grow.
Anterior hip replacement uniquely allows xray use during surgery to overlay the arthritic hip and the hip replacement images onto the opposite unaffected hip for real-time, precise, and accurate reconstruction.
To understand if this approach is appropriate for you, it is important to speak to a surgeon who has experience and actively performs the direct anterior surgery. As the only surgeons to have performed the anterior hip approach at the Institute, our team has the most expertise. Patients, physical therapists, and nurses are often amazed by the rapid recovery in these patients.
⇒ Read about patient's experiences after joint replacement at Sah Orthopaedic Associates in Testimonials, or see Patient's Stories after surgery to learn more. ⇐
Faster recovery with anterior hip replacement compared to posterior hip on opposite side
Going home same day, no pain, feeling great!
Minimally Invasive Anterior Hip Replacement Surgery
Dr. Sah interviewed about advanced pain management techniques
Anterior hip replacement patient walking before discharge home, "I don't have any pain."
Specialized OR table for Anterior Hip Replacement
Anterior hip replacement patient walking hours after surgery, "I have less pain than I did before surgery!"
Read a patient's experience with hip replacement in this article:
For more information, read this PDF below:
Alexander Sah, "Best practices in patient education and satisfaction for Total Joint Arthroplasty", Presentation at Palacademy Webinary, 2020
Alexander Sah, "Anterior approach in the Outpatient Setting", Presentation for Anterior Advantage Symposium at AAHKS Annual Meeting, Dallas, 2019
Alexander Sah, "Cemented femoral fixation and Anterior Hip Replacement", Presentation at Anterior Hip Foundation Annual Meeting, Las Vegas, 2019
Alexander Sah, "Optimal pain management with periarticular injections in anterior hip replacement",Presentation at Anterior Hip Foundation Annual Meeting, Las Vegas 2019
Alexander Sah, "Understanding the Learning Curve- Comparison of the first 100 Direct Anterior THAs to concomitant established Mini-posterior THAs", Presentation at Anterior Hip Foundation Annual Meeting, Las Vegas, 2019
Alexander Sah, "Understanding the Learning Curve, Comparison of the first 75 Direct Anterior THAs to concomitant established Mini-posterior THAs", Poster at Orthopedics Today Annual Meeting, Hawaii, 2019
Alexander Sah, "Anterior approach hip replacement- Progressive techniques and technologies", Presentation at Medtronic National Webinar, 2018
Alexander Sah, "Updates in Hip Replacement- Surgical approaches and Controversies", Presentation at PhysicalTherapy.com, 2018
Alexander Sah, "What's New in Joint Replacement", Moderator of Arthroplasty Section at COA Annual Meeting, SF, 2018
Alexander Sah, "Lessons learned in the early experience with anterior hip replacement", Presentation at Anterior Hip Foundation, Las Vegas, 2018
