Anterior Total Hip Replacement

x-ray example of hip arthritis and hip replacement
Hana table used for anterior approach total hip replacement
What is total hip replacement?
 

The hip joint is a ball and socket joint.  Hip arthritis develops when the cartilage between the two parts wears out so that the joint is "bone-on-bone" (see left x-ray above).  Total hip replacement involves making an incision down to the joint, removing the arthritic portions of the hip joint, and inserting metal and plastic implants. Special instruments are used to shape the bones to fit the implants. The components are usually put in without using bone cement because the implants are coated to promote bone to grow into the metal parts for long term fixation.  The parts of a hip replacement include the cup, the stem, the ball, and the liner (see image on FAQs page).  The cup and stem are always made of metal, the ball can be either metal or ceramic, and the liner is usually plastic. When both the ball and liner are metal the hip replacement is considered metal-on-metal.  This combination has some benefits but is done less commonly now because some patients have an adverse reaction to the metal-on-metal bearing surface.  The goals of total hip replacement surgery are to take away the hip pain associated with hip arthritis, to increase a patient's mobility, and make a stable joint  that recreates the patient's normal hip biomechanics. It is one of the most successful procedures in all of medicine with the vast majority of patients experiencing near complete or complete hip pain relief for 20 years or longer.

What is anterior total hip replacement?
 

Direct anterior total hip replacement is a way of doing hip replacement that has become popular recently amongst both patients and surgeons.  It has become more popular because of the increasing availability of the Hana® operating table.  The Hana® table allows for unique positioning of the hip that makes the anterior approach more facile for the surgeon.  The incision is made on the front of the hip instead of on the side (lateral) or in the back (posterior).  It allows the surgery to be done by going in-between the muscles rather than cutting through them.  The potential advantages of the anterior approach include quicker recovery, less pain, lower dislocation rate, no required hip precautions, and easier ability to check leg lengths and hip offset to better recreate normal hip biomechanics.  Patients typically require less time in the hospital postoperatively because of the quicker recovery.

 

Posterior approach total hip replacement is the most common way for hip replacements to be performed in the United States.  This approach requires splitting the gluteus maximus muscle as well as incising the tendons of the short external rotator muscles in the back of the hip.  Because of the muscles and tendons that are disrupted, the recovery process can be slower and hip precautions are usually necessary postoperatively to prevent hip dislocation.  This is why most patients after total hip replacement cannot cross their legs, cannot sit in low chairs, and have to be careful how they bend over to prevent dislocation.  These hip precautions are not necessary after anterior total hip replacement.

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Prince William Orthopaedics

8525 Rolling Road, Suite 300

Manassas, VA 20110

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Patient Testimonials

Healthgrades.com 

"I talked with over four orthopedic surgeons and their staff before selecting the surgeon for my knee replacement. I am pleased I chose Dr. Weidner. He is an excellent Surgeon. His PA, Ms. Richardson, spent over 30 minutes on the phone talking to me about things as the best use of pain medicine, excellent staff. Dr. Weidner uses the latest technology as robotics wisely. He is very willing to talk and work with me as the patient. I highly recommend Dr. Weidner."

"Dr. Weidner replaced my right hip and after one year replaced the left hip. I send my heartfelt gratitude, thank you for everything you have done for me. It is wonderful not to walk around in pain anymore. Not many people have a chance to say they have as great of doctor as I do."

"Dr. Weidner was referred to me by another doctor who was unable to address the issue with my knee after it became infected from an initial surgery (not done by Dr. Weidner). At the very first visit, Dr. Weidner was personable & took the time to answer my questions unlike most docs who rush you in/out. Every visit thereafter, Dr. Weidner's calm & positive approach left me feeling confident that I would finally have use of my knee. To date, I am farther along than I have ever been. Awesome doc"

"Dr. Weidner is great he has done 3 knee surgeries on me and I wouldn’t want any other doctor. He listen to what you have to say and works with you until he finds a solution."

"I highly recommend Dr. Weidner. Fell on the ice and required knee surgery. Excellent results and speedy recovery. He explained all aspects of surgery and how to best care for the knee. He is an excellent surgeon with a very caring attitude. Follows up to ensure everything is progressing as expected. Recently had an issue with rotor cuff and he once again demonstrated his professional competence through alternative options to prevent a worsening condition. Outstanding professional."

Google

"Dr. Weidner is a great doctor. Takes the time to talk to you and really does care. Had a left hip replacement earlier this year and in spite of my age and physical condition, it was relatively pain free shortly thereafter. Hip works great. He's going to do my other hip in a couple of months. No worries here. I should add that the office is very nice and all of the assistants are very courteous and responsive."

"The best ever... the man is an artist!!! I've had 2 surgery procedures done, and both effective!!"

Vitals.com

Total Hip Replacement Self-verified patient of Dr. Zachary D Weidner - "Did a great job and great bedside manner!"

"I have been to multiple orthopedic offices over the past ten years and PW Ortho is among the very best. Excellent staff from the front office to the medical assistants. Dr. Weidner is excellent as well. Very personable and attentive"