Direct Anterior Hip Replacement

Traditional hip surgery has an excellent track record of successfully relieving pain from severely arthritic hip joint disease. However, those conventional techniques require some limited dissection, (cutting through), of some important components of our gait, (pattern of walking).  These muscle groups are the gluteus medius and short external rotators

The direct anterior approach to the hip is essentially the same operation in terms of hip replacement components, but it is the one technique that goes completely between these muscle planes.  The main advantage to this lack of muscle dissection means patients will not have the postoperative limp associated with the conventional hip replacement technique.

Hecht_anterior-hip-replacement-image copyI have over 25 years experience doing hip replacement surgery.  I initially learned the direct anterior approach using the technique originally pioneered by Dr. Kristaps Keggi in the 1970’s, and later championed by his nephew, Dr. John Keggi from Middlebury, CT.

Their technique does not require a special traction table during surgery.  Having the patient on their back and their entire leg free during the procedure permits the surgeon more flexibility and is safer for the patient.

Although a traction table can be used with this technique it adds some risk to the patient, including intraoperative, (during surgery), fractures and traction injuries.  More extensive x-rays are also needed when using the traction table.

Although all minimally invasive hip techniques involve a single 3-4 inch incision the benefits of using the direct anterior approach over other techniques include:

  • Slightly lower risk of post operative blood clots, (DVT), possibly because there is less twisting of the leg during surgery.
  • Patients lie on their back during surgery rather than their side.  This makes it easier for the anesthesiologist to monitor them.
  • Lying supine, (on your back), during surgery also makes it easier for the surgeon to measure and match the leg lengths.  These means there’s a smaller chance of needing a shoe lift after surgery.
  • Finally, some patients are walking without a limp or cane in as little as 2 weeks because the “walking muscles” were not dissected during surgery.


Hecht_Off_#1_photo-15 copyWhy Dr. Joseph Hecht?

Dr. Hecht is board certified in orthopedic surgery, providing expert knowledge and expertise in the area of hip conditions and treatment options.  As one of the top Northwest Indiana and Chicagoland hip surgeons, Dr. Hecht brings years of valuable experience to every hip assessment.

Direct Anterior Approach to Hip Replacement Surgery