Most hip replacements are done through the buttock or over the side of the hip with large incisions and detachment of muscles and tendons, known as the “Posterior” and the “Lateral” approaches. During the Vietnam war, my mentor, Dr. Kristaps Keggi developed the “Anterior”, or front approach to the hip, which spares the muscles and tendons. The surgery takes about 45 minutes with a 4 – 5” scar in the front of the hip. Any patient or therapist who has experienced both techniques will testify that the patients with the anterior approach recover faster and with substantially less pain. No muscles or tendons are detached and the cardiopulmonary status is uncompromised by a side lying position. It is a safer procedure.
In 1983 at Yale University, Dr. Keggi trained me to do the Anterior approach. Since then, I have steadily made the incision smaller with better instrumentation, implants, and technique, subsequently shortening the hospital stay and recovery. For many of my patients, total hip replacement is almost a non-event.
Lately, there has been increasing interest in this less invasive technique and even false advertising to suggest that it is a recent innovation. The technique begins in the late 1960’s and was published widely in the late 70’s. It has just not been widely taught, and as such most surgeons are not comfortable doing it because of lack of experience. Like all surgical procedures, there is a learning curve. You do not want to be part of some surgeon’s learning curve. I have been routinely doing this approach for 30 years.