Minimally Invasive Direct Anterior Total Hip Replacement (THR)

MEDICAL ANIMATION TRANSCRIPT: Your hip consists of two main parts that fit together like a ball and socket-- the femoral head at the top of the leg and the acetabulum in your pelvis. Cartilage between the femoral head and acetabulum provides cushioning between the bones and allows for smooth movement. A total hip replacement is usually done when severe damage from arthritis or injury has made it difficult to perform daily activities without severe pain or restricted range of motion. During the procedure, the femoral head and acetabulum are replaced with artificial components called prostheses. An artificial hip prosthesis consists of a cup, called the acetabulum component, and a stem and a ball, called the femoral component. During a direct anterior total hip replacement procedure, you will lie on your back on a specialized table, enabling your surgeon to perform this minimally invasive operation. Your feet will be placed in boots attached to the table, allowing your surgeon to position your legs as necessary to gain access to your hip joint during your operation. A fluoroscopy machine may be used during the procedure to help your surgeon position your prosthesis more accurately. Your surgeon will begin by making a 3- to 6-inch incision near your groin. This incision is significantly smaller than those made during other total hip replacement procedures. He or she will then push aside two muscles to expose the joint capsule. No muscles are split or detached during this procedure. After incising the joint capsule, your surgeon will dislocate the femoral head from the acetabulum. He or she will remove any damaged cartilage or bone in the acetabulum, reshape the acetabular socket, and secure the acetabular prosthesis in place using special cement or screws. Turning next to the femur, your surgeon will remove the femoral head, shape the remaining femur to fit the prosthetic stem, and secure the femoral component using cement or other techniques. Once both components are firmly in place, your surgeon will slide the prosthetic femoral head into its acetabular counterpart, test the movement of your new hip joint, and may verify that it is properly positioned with an X-ray. Your surgeon will then close the joint capsule and reposition your muscles. He or she may place a drain in your hip to remove excess fluid and close the incision with stitches or staples.