1. Vahan Cepkinian, M.D. Orthopaedic Surgery
Anterior Approach Total Hip Replacement: Cutting Edge Treatment for the Relief of Hip Pain
Vahan Cepkinian, M.D.
Orthopaedic Surgery

2. Introduction
Hip arthritis affects hundreds of thousands of people each year
Many people suffering from arthritis alter their lives to deal with pain.

3. Introduction Non-surgical treatment Medications Physical Therapy
Assistive Devices
If these do not work then hip replacement may be the solution

4. Total Hip Replacement
The goal is to reduce hip pain and improve the motion in your hip.
More than 345,000 people in the United States annually undergo hip replacement surgery.

5. Anatomy of the Hip Ball and socket joint
Femoral head or ball is at the end of thighbone or femur.
Socket or acetabulum holds the ball.

6. Anatomy of the Hip
The arthritic hip has worn down cartilage and rough bone which cause pain

7. Total Hip Replacement
Involves surgically removing the arthritic parts of the joint (cartilage and bone), and replacing the ball and socket part of the joint with artificial components

8. Total Hip Replacement
Acetabular component - consists of two components
Cup - usually made of titanium
Liner - can be medical grade plastic, metal or ceramic

9. Total Hip Replacement
The femoral component (stem and neck portion), is made of metal.
Femoral head is made either of metal or ceramic.
Stem is shaped to fit into the bone and support the new joint.

10. Total Hip Replacement
One of the most successful adult reconstructive procedures performed in orthopaedics
With newer materials, hip replacements can last up to (and sometimes beyond) years!

11. Total Hip Replacement The Traditional approach
The hip is approached from the back
Disrupts the tissue and muscles important for the stability of the hip
Involves detachment of muscles from bone
Large incision (12-18 inches)

12. Total Hip Replacement Traditional Approach
Disrupts the tissue and muscles important for the stability of the hip

13. Total Hip Replacement Traditional Approach
There is the risk of hip dislocation
Limitations on hip motion and positions
There is the risk of a persistent limp
Greater reliance on assistive devices (walker, cane) post-operatively
Over 6 weeks
Greater need for pain medication

14. Total Hip Replacement Traditional Approach
All of these factors make people hesitant to proceed with a hip replacement…..and they continue to live in pain!

15. Total Hip Replacement Anterior Approach
The Anterior Approach
Approach the hip from the front
NO DISRUPTION of MUSCLE
MINIMAL TRAUMA to the TISSUES
MUSCLE SPARING APPROACH
MUCH SMALLER INCISION (4-5 inches)

16. Total Hip Replacement Anterior Approach
The hip is exposed by going in between the muscles WITHOUT DISRUPTING THEM
Muscle Sparing

17. Total Hip Replacement Anterior Approach
Compare the depth of muscle and tissue one has to go through

18. Total Hip Replacement Anterior Approach
This approach is made possible with the use of a special orthopaedic table called the HANA table which is found at Glendale Memorial Hospital

19. Total Hip Replacement Anterior Approach
A small amount of X-ray is also used during the surgery to get an exact picture of the position of the implants
This ensures that all of the hip components are in the perfect place and that the leg lengths are equal

20. Total Hip Replacement Anterior Approach
Essentially NO risk of dislocation
NO limitation of hip range of motion and positions
Less Reliance on Assistive Devices
Usually 2 weeks
Less pain!
FASTER RECOVERY!

21. Total Hip Replacement Anterior Approach
These advantages when compared to the traditional approach can eliminate apprehension
QUICKER RECOVERY TO AN IMPROVED QUALITY OF LIFE !

22. THANK YOU