The short answer is almost everybody is a candidate for anterior approach hip replacement.
The only real exceptions are cases where it is necessary to access the back of the hip joint. This might be to remove screws or plates from prior surgeries, or where there are deficiencies in the bone at the back of the joint that need some form of augmentation.
Benefits of Anterior Approach Hip Replacement for Patients with High BMI
There’s a misconception that patients over a certain BMI are not suitable for anterior hip replacement. It’s true that if patients have a BMI of 50+ we do like to try to get that down to the 40-45 range – but that’s because we know that certain risks increase with weight – not because of the surgical approach. (Read more about our pre-surgical optimization that ensures the best possible outcomes.)
In fact, Dr. Mast believes that conducting hip replacement surgery for larger patients from the front is preferable. Firstly, there’s less tissue to contend with compared to a posterior or anterior lateral approach. The same tissue means that from these approaches, many of the bony landmarks that surgeons typically rely on to determine effective component placement are also harder to identify.
With an anterior surgery – an incision in the hip crease means there’s limited soft tissue to deal with (check out the other benefits to bikini incisions here). In addition, the fact that the patient is lying on their back makes it possible to use X-ray throughout to ensure accurate component positioning.
