- SPECIALIST ORTHOPAEDIC SURGEON | MELBOURNE, VIC | ALBURY NSW |
- 03 9421 6133
Anterior Approach Total Hip Replacement Surgery
A muscle-sparing technique for hip joint replacement: Anterior Minimally Invasive Surgery (AMIS)
If you’re considering hip replacement surgery, you may have heard about the anterior approach, a modern surgical technique that accesses the hip joint from the front of the body, avoiding major muscle groups that are usually involved in traditional techniques. By working between the natural spaces in the muscles, rather than cutting through them, this method can help preserve important structures that support walking, balance, and recovery.
Where appropriate, Dr Hockings may also use a bikini incision, with the AMIS approach, a refined technique where the surgical cut is made along the natural skin crease at the front of the hip, resulting in a less visible scar once healed. Also, to support accuracy and consistency during surgery, he may also use advanced planning and intraoperative tools. These technologies work together to support a well-aligned, stable outcome tailored to your individual anatomy.
Around 2.1 million Australians (1 in 11 people) have osteoarthritis, with a 58% increase expected by 2032 due to population ageing and rising obesity rates
What is anterior approach hip replacement?
Anterior approach total hip replacement, also know as DAA or AMIS, is a surgical technique used to perform total hip replacement through an incision at the front of the hip. This method allows the surgeon to access the joint by moving between muscles rather than cutting through them. It’s considered a muscle-sparing approach, as it preserves key structures such as the gluteal and rotator muscles, which are important for hip stability and mobility.
The anterior approach is performed with the patient lying on their back (supine), which allows for easier access to both hips if needed, and helps maintain accurate positioning during the procedure. For many patients, this can lead to a smoother and more confident recovery.
How is it different from other hip replacement techniques?
Traditional hip replacement surgery is often performed using a posterior (from the back) or lateral (from the side) approach. These techniques usually require the surgeon to detach or split through important muscles and tendons to reach the joint. In contrast, the anterior approach uses a natural interval between muscles at the front of the hip. This means:
- No muscle detachment is required to reach the joint
- Key stabilising muscles are preserved
- The risk of posterior dislocation may be lower
- Post-operative movement restrictions may not be needed
Dr Hockings performs the anterior approach in the majority of his hip replacement cases and will recommend the most appropriate surgical method based on your individual needs.
Potential Benefits of the anterior approach
The direct anterior approach for total hip replacement surgery offers several benefits compared to traditional surgical approaches. One notable advantage is the potential for a faster recovery and shorter hospital stay. This is attributed to the fact that the surgery is performed through a smaller incision at the front of the hip, avoiding disruption of key muscles and tendons. The approach allows for a more tissue-sparing technique, reducing trauma to surrounding structures and minimising postoperative pain. Patients undergoing direct anterior hip replacement often experience improved early postoperative mobility and reduced muscle damage, contributing to a quicker return to activities of daily living. Additionally, the reduced muscle trauma may lead to a lower risk of dislocation after surgery. While not suitable for all patients, the direct anterior approach represents an innovative and minimally invasive option for total hip replacement, providing potential advantages in terms of recovery time, postoperative pain, and overall patient satisfaction.
It’s important to remember that every surgical technique has risks and benefits. Dr Hockings will explain these in detail and help you decide whether the anterior approach is right for you.
Who is suitable for this technique?
Many patients with hip osteoarthritis, avascular necrosis, labral damage, or post-traumatic arthritis may be suitable for anterior approach hip replacement. This technique may be particularly beneficial for:
Imaging tests may include:
- X-rays to check for joint space narrowing, bone spurs (osteophytes), and other arthritic changes
- MRI scans if soft tissue structures such as the labrum or cartilage need further evaluation
These investigations help confirm the diagnosis and guide treatment options.
Non-surgical treatment options
In the early stages of osteoarthritis, symptoms may be managed effectively with non-surgical strategies.
These may include:
- Patients seeking a faster return to movement
- Those wanting to avoid post-operative restrictions
- People with good bone quality and soft tissue condition
- Individuals considering bilateral hip replacement
This technique, however, may not be suitable for everyone as certain factors such as severe obesity, unusual bone anatomy, or revision surgery may require an alternative approach. Dr Hockings will carefully assess your situation and explain the best surgical option for your needs.
How the anterior approach technique is performed
Dr Hockings performs anterior hip replacement with the patient lying on their back (supine), using a specialised orthopaedic table and surgical instruments designed for this technique. The procedure typically includes:
Common signs that surgery may be appropriate include:
- Making a small incision at the front of the hip, or along the natural skin crease (bikini incision)
- Working between muscles to access the joint without cutting through them
- Removing the damaged femoral head and preparing the hip socket
- Inserting the acetabular cup and femoral stem
- Using intraoperative X-rays to confirm precise implant positioning and leg length
- Closing the incision with dissolvable stitches or skin glue
MyHip pre-operative planning software is used to map out the surgery in advance, helping ensure the prosthesis is well-suited to your anatomy.
Post-op precautions following anterior approach total hip replacement
Because the anterior approach avoids cutting key stabilising muscles, many patients are not required to follow strict movement restrictions after surgery.
Typically, patients are allowed to:
- Sit in regular chairs
- Cross their legs
- Sleep on their side
- Begin walking with support on the same day or the day after surgery
Some patients however, may still be advised to take precautions depending on their specific case. Dr Hockings and your physiotherapy team will provide clear, personalised guidance to help you recover safely and confidently.
Recovery after anterior hip replacement
Recovery timelines vary depending on your health, fitness level, and the complexity of your surgery. In general:
- Most patients stay in hospital for 1–2 nights
- Walking aids such as crutches or a frame are used in the early days
- Physiotherapy begins shortly after surgery and continues after discharge
- You may return to light daily activities within 2–4 weeks
- Driving can usually resume by 3–4 weeks (once cleared by your surgeon)
- Most people return to work within 4–6 weeks , depending on the nature of their job
- Full recovery can take 3–6 months , or longer in complex casesks, depending on the nature of their job
Dr Hockings and his team will provide a tailored rehabilitation plan to help you get back to the activities you enjoy.
During your consultation, Dr Hockings will explain the most appropriate surgical approach based on your condition, anatomy, and individual needs. Many people experience a significant improvement in pain, function, and mobility following hip replacement surgery. Recovery timelines vary depending on the surgical approach and your overall health, but most patients gradually return to walking, driving, and normal activities over the course of several weeks to months.
If you’re living with hip pain or stiffness that’s affecting your quality of life, a thorough assessment can help determine the cause and guide the right treatment path.
