Dr. Zachary Weidner, M.D.
Fellowship Trained in Hip & Knee Replacement
Board Certified Orthopedic Surgeon
Expert for Pain from Hip and Knee Arthritis
VISIT US
The Centers for Advanced Orthopaedics
Prince William Orthopaedics
8525 Rolling Road, Suite 300
Manassas, VA 20110
Fair Oaks Office
3650 Joseph Siewick Dr, Suite 300
Fairfax, VA 22033
FOR APPOINTMENT CALL 703-393-1667 or schedule online via link below!
Anterior Total Hip Replacement
Two examples of patients of Dr. Weidner's that underwent minimally invasive anterior total hip replacement surgery. Notice how well they are walking without use of cane or walker only two weeks after surgery.
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.
FAQs — Anterior Total Hip Replacement
Q: What is anterior hip replacement?
A: Anterior hip replacement is a minimally invasive approach to total hip replacement surgery in which the hip joint is accessed from the front of the body. Because the surgery works between muscle groups rather than cutting through them, patients typically experience less pain, a faster recovery, and fewer activity restrictions compared to traditional posterior hip replacement.
Q: How is anterior hip replacement different from posterior hip replacement?
A: The posterior (back-of-hip) approach requires cutting and later repairing major hip muscles, including the gluteus. The anterior approach goes between natural tissue planes, preserving muscle integrity. This generally means less post-operative pain, a faster return to walking without an assistive device, and no need for "hip precautions" — the movement restrictions often required after posterior hip replacement.
Q: How long does anterior hip replacement surgery take?
A: The surgery typically takes 60–90 minutes. Total time at the surgical facility, including preparation and recovery, is usually 4–6 hours. Outpatient patients may go home the same day.
Q: Will I need to stay in the hospital?
A: Many patients are eligible for outpatient (same-day) anterior hip replacement, meaning they go home the day of surgery. Other patients stay one night at the hospital. Dr. Weidner will determine the appropriate setting based on your health, home situation, and preferences.
Q: When can I walk after anterior hip replacement?
A: Most patients are walking with a walker just hours after surgery. The goal is to be up and moving the same day. Most patients transition from a walker to a cane within 1-3 weeks, and many are walking without any assistive device by 3-6 weeks.
Q: What are the activity restrictions after anterior hip replacement?
A: One of the advantages of the anterior approach is that most patients have minimal activity restrictions after surgery. Unlike posterior hip replacement, there are typically no restrictions on bending the hip or crossing the legs. Dr. Weidner will provide specific guidance based on your individual case.
Q: When can I drive after hip replacement?
A: If your left hip was replaced and you drive an automatic vehicle, you may be able to drive in less than 2 weeks. Right hip replacement patients typically return to driving at 2-3 weeks, once they can reliably perform an emergency stop. Dr. Weidner will advise you at your follow-up appointments.
Q: How long does it take to fully recover from hip replacement?
A: Most patients return to normal daily activities within 2-6 weeks. Full recovery — including the ability to participate in higher-impact activities — typically occurs between 6 and 12 months. Individual results vary based on age, overall health, and activity level.
Q: What is the success rate of hip replacement surgery?
A: Total hip replacement is one of the most successful procedures in all of medicine, with patient satisfaction rates consistently above 95%. Modern implants are designed to last 20+ years in most patients. Dr. Weidner will discuss realistic expectations with you during your consultation.
Q: How do I schedule a hip replacement consultation with Dr. Weidner?
A: Call our office at 703-393-1667 or schedule online. Dr. Weidner sees patients at his Manassas and Fair Oaks offices and serves patients from throughout Northern Virginia including Haymarket, Gainesville, Woodbridge, Warrenton, and Centreville.