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Micro Direct Posterior Approach Hip Replacement

If you’re facing total hip arthroplasty (THA) – or “hip replacement” – then your physician may have told you about your many options… minimally invasive replacement, traditional replacement, direct anterior approach, direct posterior approach, SuperPATH… the list goes on.

Hedley Orthopaedic Institute is the first and only orthopaedic group in Arizona to offer the micro direct posterior approach (PA) for total hip replacement. With the micro direct posterior approach, the surgeon enters the hip from behind (as opposed to the front) using just one small incision. Because this is a micro-invasive procedure, the incision is sufficient for placing a small endoscope (camera) as well as the surgical tools. A new hip can be replaced through this incision without damaging the muscles or tendons or forcing the body into an unnatural position.

Why Choose the Micro Direct Posterior Approach for Hip Replacement?

There are many potential benefits that make the micro direct posterior approach more appealing than the anterior approach:

  • Less muscle damage
  • No hip precautions after surgery
  • Potential for outpatient hip replacement or home by the next day
  • Lower dislocation damage
  • Minimal pain after surgery
  • Minimal pain medication required
  • Low blood loss to the patient
  • Smaller surgical incision
  • Lower complication rates
  • More natural positioning of the leg during surgery with less twisting of the extremity involved

Micro Direct Posterior Approach v. Direct Anterior Approach

Your physician may have brought up both the direct posterior and the direct anterior approach in the same conversation. The first procedure is done through an incision on the buttock, between the side and the back of the hip, following the body’s natural curves. In the second procedure (anterior), the incision is done on the front of the body between the upper thigh and hip.

With the micro direct posterior approach, the surgeon doesn’t have to cut the muscles (which causes unnecessary pain and risk, while prolonging the recovery process). Instead, the surgeon separates the muscle fibers. This greatly reduces the risk of nerve damage. With the direct anterior approach, however, the chance of femoral nerve damage is much greater. The femoral nerve is responsible for sensation in the front and side of the thigh.

Common Problems With Direct Anterior Approach

In addition to the possibility of femoral nerve damage, the direct anterior approach has many potential problems:

  • Visualizing the femur can be difficult in the direct anterior approach. As a result, there is a greater possibility that the surgeon may misjudge where the incision should be made. Unnecessary damage to the skin, internal tissues, femoral nerve, and blood vessels is possible.
  • Overweight, muscular, or short patients can be a challenge for the surgeon in the direct anterior approach for the above reason.
  • Due to difficulties in visualizing the femur, it is not uncommon for surgeons using this approach to choose a femoral stem that is most convenient – not necessarily the best fit for the patient’s anatomy.

At Hedley Orthopaedic Institute, your surgeon can provide you with as much information as you need to choose the right procedure. Total hip replacement surgery is a major decision, and you deserve to have the procedure that’s right for your anatomy and lifestyle. To schedule an appointment with an orthopaedic surgeon in Phoenix, Tempe, or Mesa, contact us. Ask about the Micro Direct Posterior Approach! Or, schedule an appointment online.



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