You are here
Hip Anterior Approach
The anterior approach to the hip joint is a technique used to perform a variety of procedures, including total hip replacement.
The anterior approach to the hip is also known as the Heuter Approach, the Direct Anterior Approach (DAA), Anterior Supine Intermuscular approach (ASI), Minimally Invasive Surgery (MIS) Anterior Supine Approach, Anterior Minimally Invasive Surgery (AMIS).
What are the advantages?
The benefit of the anterior approach for hip replacement is as the approach allows access to the hip joint exploiting the interval between muscles. There is no cutting of muscle required. There is scientific evidence to demonstrate that patients having this approach may have a shorter stay in hospital and a less painful, and more rapid recovery, compared to other approaches.
As muscles are not cut, the anterior approach provides a more stable hip replacement. At this stage, long-term studies have not yet demonstrated a difference in function between the different approaches for a total hip replacement.
What are the downsides?
Due to the anatomy of the superficial nerves in the region of the approach, there may be a numb patch of skin on the outer aspect of the thigh. This usually reduces significantly over time, but may be persistent.
Is the Direct Anterior Approach for everyone?
The reason for requirement of hip surgery varies in all patients. Although most patients may be suitable for the anterior approach, some patients are not suitable due to the shape of the bone and the type of implant needed to address the pathology. Alternative approaches to the hip are available.
What alternatives are there?
There are a multitude of alternative approaches to the hip joint to perform hip replacement. Dr Agolley prefers the posterior approach in the majority of cases that are not DAA.
Some may ask, “Which approach is ‘better’ than the other?”
No one approach is necessarily better or worse, as different pathology requires different treatment, and each approach has their advantages and disadvantages.
Does it make a difference in the long term which approach I have?
The most important factor for a hip replacement to be successful and provide long term function and pain relief, is that the hip replacement is performed technically well, with implants that are likely to give an excellent outcome. There is currently no evidence to definitively prove that one approach provides better function than the other in the long term.
Does Dr Agolley perform the Direct Anterior Approach?
Yes, Dr Agolley uses the anterior approach in suitable patients requiring hip replacement.
Dr Agolley uses implants that have shown to have some of the lowest revision rates, and bearing surfaces that have some of the lowest revision rates on the Australian National Joint Registry.
Dr David Agolley performs complex hip replacement procedures with some of the most reliable prostheses and modern techniques including minimally invasive direct anterior approach hip replacement.