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minimally invasive direct anterior approach » minimally invasive direct anterior approach

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hips that work!

Here are two examples of patients of mine who have had both hips replaced via a minimally invasive direct anterior approach.  The first patient is a very active physician from Alaska who developed severe bilateral osteoarthritis of the hip joints.  He was initially very reluctant to undergo surgery (no doctor likes a taste of their own medicine) but ultimately he chose to have me replace both of his joints.  In this case, we did both operations at the same time.

Here are his pre-operative xrays.  Notice how the cartilage has worn away and there is no joint space left inside the acetabulum.  Also, the lack of cartilage on the femoral head has allowed subchondral cysts to develop which are associated with severe arthritis.

preoperative AP xray severe osteoarthritis of the hip joints preoperative xray left hip severe osteoarthritis preoperative lateral xray subchondral cyst formation

and here are his post-operative xrays.  In this case, the patient’s size (he is a physically big man) and the strength of his bone made the direct anterior approach quite challenging.  Since I new he would push very hard in rehabilitation I put a cable around the proximal portion of the femur on both sides in order to prevent a crack from when he put all of his weight on both hips immediately after surgery.

postoperative xray direct anterior bilateral total hips post operative lateral xray direct anterior minimally invasive hip surgery post operative left xray direct anterior minimally invasive hip surgery

And here he is skiing in the backcountry in alaska, 6 months after his operation.

skiing after bilateral total hip arthroplasty

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