Disclaimer: This information is an educational resource only and should not be used to make a decision on the type of total hip replacement you should have. All decisions must be made in conjunction with your surgeon or a licensed healthcare provider.

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The Antero-lateral aPPROACH

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In the conventional-antero-lateral approach the hip abductor (gluteus medius and minimis) muscles/tendons are detached and split. This approach also cuts through the tendons of gluteus maximus and tensor fascia lata muscles.

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THE Posterior APPROACH

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In the conventional-posterior approach the gluteus minimis muscle is cut off the capsule. The posterior approach also cuts through the tendons of gluteus maximus, tensor fascia lata, piriformis, gemelli and obturator muscles.

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The Direct Anterior Approach

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The direct anterior approach incision is only 7-10cm in length, whereas antero-lateral or posterior approach incisions are usually between 15 - 30cm in length.

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With the direct anterior approach there is no detachment, splitting or denervation of muscle. No muscles or tendons are cut as they are simply retracted to create a gap. The tensor fascia lata muscle is retracted laterally whilst the rectus femoris muscle is retracted medially. There is no gluteal (buttock) muscle injury with this approach.

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The gluteal muscles provide the main hip power and stability and as they are entirely intact with the direct anterior approach a faster recovery is expected.

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The direct anterior approach enters between the nerve supply to the muscles so the muscle fibres retain their full ability to function after the operation.

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Other approaches permanently damage either muscle fibres and/or the nerves which supply them so there may be a permanent loss of nerve function and/or partial muscle wasting.

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Remember that ALL approaches if performed correctly will result in a successful pain free outcome that should last at least 20-30 years using modern day implants.

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