While not new, anterior hip replacement is performed using a special Hanna table using smaller incisions with more specialized instrumentation to help make this surgery less traumatic and therefore, less painful for the patient.
All hip replacements, regardless of incision type, require your surgeon to replace the top of the thigh bone and the socket of the pelvis. There are a number of ways for your surgeon to perform this task, as your surgeon can approach your hip from the back of the joint (posterior approach), the side of the joint (lateral or anterolateral approach), the front of the joint (anterior approach), or through a combination of approaches (two-incision approach).
Key to each of these approaches is that in this surgery, the ball and socket of the hip joint are replaced by a prosthetic implant. Some implant models tend to be better suited to insertion through one or more specific approaches but generally, any implant can theoretically be used for any approach. Your surgeon dictates which will be use based on professional experience and preference.
What drives up cost of the implant are the price variables between suppliers and manufacturers and the markup added by the hospital or ASC. And in some cases, we’ve observed where a powerful hospital in a particular market will threaten the supplier, GPO or with reduced purchasing or refusal to deal if they charge competitors such as independent ambulatory surgery centers or other hospitals the same or a lower price. If we observe this or hear about it through the grapevine and can confirm this, we will eject the anti-competitive organization out of our network, first, but immediate pend status, and upon confirmation, total removal and blacklisting. We believe in fairness and transparency in all dealings to make healthcare affordable.
Greed and anti-competitive bullying in the marketplace injures the spirit of competition and forces higher prices on consumers and third-party payers such as insurers and self-funded employers and labor union health and welfare plans.
What’s different about the anterior hip replacement?
The anterior approach hip replacement is a muscle-splitting approach, meaning that the surgeon gets to the hip between two muscles, rather than by removing and then reattaching a muscle.
Among orthopedic surgeons, the advantage is that post-operative rehabilitation may be achieved sooner because the time to allow the reattached muscle to heal is nearly eliminated. Similar to other minimally invasive surgery, with a smaller incision size, post-operative discomfort and incision complications risks are lower. Also, many surgeons tell us that as newer implants are approved, some surgeons agree that a lower dislocation rate this is no longer a distinct advantage of the anterior approach hip replacement. Across hip replacement surgical approaches, many surgeons tell us that complications associated with anterior approach hip replacement are similar to standard hip replacement complications. One specific incision and operative complication is injury to a large skin nerve (the lateral femoral cutaneous nerve) just to the side of the incision of the anterior approach hip replacement. If during the procedure, this nerve is injured, the damage lead to chronic pain and abnormal sensations along the front and side of the thigh. The Hana table aids in positioning the patient on the operating table to help mitigate the risk of the damage to the nerve and the muscle splitting, but its just a table. The risk is also dependent on surgeon skill and experience.
Is an anterior hip replacement “better” than other approaches?
