Hip surgery can offer greater mobility.

Published 12:00 am Monday, August 13, 2012

1.  What is direct anterior hip replacement?
Traditional hip replacements are accomplished by reaching the hip joint from the side or the back of the hip.  These techniques require muscles and tendons to be released from the bone in order to perform the surgery.  This results in increased healing time, increased blood loss, and decreased stability of the hip joint.
Direct anterior hip replacement is a minimally invasive technique that allows the surgeon to reach the hip joint through the front by going in between muscles.  There is no need to release any muscles or tendons.  This typically results in shorter hospital stays, less pain, and quicker return to activities.
2.  What are the advantages of direct anterior hip replacement?
Minimally invasive surgery 
Anterior hip replacement incisions are 4-5 inches as compared to the typical 10-12 inch incision used for the standard techniques
Less muscle trauma
Blood tests after surgery can indicate the amount of muscle trauma sustained during the operation.  Studies have shown direct anterior replacement to have less trauma than standard techniques

Faster recovery
Typical recovery is 6-8 weeks with direct anterior hip replacement as opposed to 12 weeks for standard techniques

More accurate leg lengths
A hip surgery which results in one leg being longer than the other can be very troubling for patients.  The direct anterior technique allows use of live x-ray during surgery to get leg lengths exactly equal.  This is not possible with standard techniques

Lower risk of dislocation
No muscles or tendons are released with direct anterior hip replacement surgery.  This allows for a much more stable joint after surgery.  Direct anterior hip patients do not need to follow typical restrictions given to patients having standard hip replacement, including to bending over or crossing legs

Less postoperative pain

Less blood loss

Faster return to activity

3.  With so many advantages, why don’t most surgeons perform direct anterior hip replacements?
Currently, a vast majority of surgeons in the US do not perform direct anterior hip replacement surgery.  Direct anterior hip replacement is a specialized technique which requires a substantial amount of training to perform correctly.    It has a steep learning curve and most surgeons are already comfortable with their current technique.  The surgery also requires a specialized operating table, which was recently purchased by CMC NorthEast.

4.  What experience does Dr. Ryan Bunch have with direct anterior hip replacement?
Dr. Bunch has received extensive training in anterior hip replacement at Wake Forest University.  Dr. Bunch recently completed a year long fellowship in hip and knee replacement at Wake Forest University Baptist Medical Center.  Dr. Bunch has brought his expertise in anterior hip replacement to CMC NorthEast and has worked with the hospital to acquire the specialized table and instruments necessary to perform the surgery.  Dr. Bunch is currently performing direct anterior hip replacement at CMC NorthEast.