Your Anterior Hip Replacement Recovery Guide by Weekly

If you’ve just had anterior hip replacement surgery or are planning one soon, you’re probably wondering what recovery looks like. Let me walk you through it—as if we’re sitting together with a cup of tea. I’ll share tips, reassure you, and explain everything step-by-step. Recovery is a journey, but trust me, you’ve got this! So without further ado, here is your Anterior Hip Replacement Recovery Guide.

Author Info
As a licensed Physical Therapist Assistant with over 7 years of experience, I am passionate about helping women discover how to exercise properly and heal their pain. Join me at Good Mind + Body, where we create a supportive space for women to learn, grow, and achieve their health and wellness goals.

What is an Anterior Hip Replacement?

Total hip replacement surgery, also known as total hip arthroplasty, is a surgical procedure where the damaged parts of the hip joint—the femoral head (the ball) and the acetabulum (the socket)—are replaced with artificial components. This procedure can be done using three main surgical techniques: anterior (front), posterior (back), and lateral (side).

The posterior hip replacement surgery, often called the “traditional posterior approach,” is the most commonly performed technique. However, the anterior hip replacement surgery has gained popularity as a newer option. This approach involves making a smaller incision, typically 3 to 4 inches, at the front of the hip. What sets it apart is that it avoids cutting through major muscles, which helps reduce post-operative pain and promotes a faster recovery. This muscle-sparing technique is why many patients experience improved mobility and less pain early in their healing process.

Anterior Hip Replacement Recovery Guide

Week 1:

This first week is all about patient safety and setting up for a successful recovery. You’ll need an assistive device like a walker or crutches to move short distances. Gentle exercises, guided by a physical therapist, will help improve range of motion in the hip joint and strengthen surrounding muscles.

At home, follow activity guidelines given by your healthcare team. Remember to keep the incision site clean and dry to avoid infection. You might need help from a family member or friend for activities of daily living, like cooking or picking items within easy reach.

• Pain Management:
  • You will experience some pain and discomfort.
  • Your healthcare provider will prescribe pain medication and anti-inflammatory medications if needed.
  • Take it as directed.
• Physical Therapy:
  • You’ll start physical therapy immediately to regain your new hip mobility and strengthen the muscles around the joint.
  • The standard exercises at this stage are heel slides, hip abduction, knee extension, and arm exercises.
  • Please take note of hip precautions.
• Weight-Bearing:
  • How much weight you can put on your leg (weight-bearing status) is dependent on your surgeon.
  • Most weight-bearing status is touchdown weight-bearing (only the toes of your foot touch the floor) or partial weight-bearing status (the complete front of your foot can touch the floor).
• Mobility:
  • Use assistive devices like crutches or a walker as needed.
  • Follow your surgeon’s instructions on weight-bearing and mobility.
  • The patient can resume activities of daily living, such as showering, cooking, and getting around the house.
• Incision:
  • Redness, swelling, bruising, or numbness around the incision at the hip joint is not abnormal.
• Hospital Stay:
  • It varies depending on the patient’s medical history and overall comfort. Typically, the hospital stay is 1-2 days after the surgery.

Week 2-3:

By the second week, many patients notice less pain. You’ll continue home exercises to improve the healing process and may transition to formal physical therapy. Your physical therapist will introduce hip exercises that gradually increase activity level and flexibility. Don’t forget your follow-up appointment with your orthopedic surgeon to check your progress.

Your risk of infection and blood clots decreases as you heal, but you’ll likely stay on blood thinners as a precaution. Keep your surgical site monitored and contact your doctor if you notice redness, swelling, or severe pain.

By the end of the 3rd week, you’ll start feeling like your old self again! Most people can walk short distances without assistive devices and engage in normal daily activities like light cleaning or cooking. Stick to your physical therapy plan, as strengthening the hip muscles is crucial for long-term success.

Specific precautions like avoiding certain movements or positions may still apply, depending on your type of hip replacement. Always follow your surgeon’s advice to avoid potential complications.

Week 4-6:

At this stage, you’ll likely be able to walk longer distances and might no longer need a toilet seat riser or other assistive devices (at the end of 6 weeks). Activities of daily living become easier, and your range of motion improves. Many patients notice a significant improvement in their quality of life by this point.

Your orthopedic surgeon and physical therapist will review your progress and may adjust your hip precautions. This period is critical for laying the groundwork for an active lifestyle, so stick to your exercises and recovery time guidelines.

• Pain:
  • Significantly less pain will be noted, along with decreased stillness and swelling.
• Physical Therapy:
  • In therapy, the goals here may be walking without an assistive device, balance and coordination to return to normal daily activities, and overall strength and range of motion.

Week 7-12

By the end of the first three months, the majority of patients are well on their way to a full recovery. You’ll notice increased strength in your hip joint and surrounding muscles. Depending on your overall health, you might resume gentle sports or hobbies.

Keep attending physical therapy and follow activity guidelines to prevent setbacks. Anterior hip replacement surgeries typically have a faster recovery time compared to posterior hip replacement surgery or lateral approach techniques, so enjoy your progress!

• Physical Therapy:
  • Depending on the patient’s condition, physical therapy may continue in an outpatient setting to increase strength and range and improve life quality.
• Return to Normal Activities:
  • You can start returning to your usual activities. Please continue to avoid high-impact or strenuous exercises.

If you are still having lingering thigh pain after a total hip replacement surgery, it maybe due to these reasons in this post.

5 Key Tips for a Successful Recovery

1. Listen to your body: 
   • Avoid overexerting yourself and rest when needed.
2. Stick to your exercises: 
   • Gentle, consistent hip exercises can lead to a quicker recovery.
3. Follow your surgeon’s advice: 
   • Adhering to hip precautions and following guidelines can prevent complications.
4. Prioritize your incision site: 
   • Keep it clean to minimize the risk of infection.
5. Stay active (but careful): 
   • Engage in safe activities to improve your range of motion and overall health.

Activities After an Anterior Hip Replacement

Recommended Activities

• Stationary bike
• Croquet
• Ballroom dancing
• Golf
• Horseshoes
• Shooting
• Shuffleboard
• Swimming
• Doubles Tennis
• Walking

Activities Only With Professional Experience

• Low-impact aerobics
• Road biking
• Bowling
• Canoeing
• Hiking
• Horseback riding
• Cross-Country Skiing

Activities NOT Recommended

• High-impact aerobics
• Baseball/softball
• Basketball
• Football
• Gymnastics
• Handball
• Hockey
• Jogging
• Lacrosse
• Racquetball
• Squash
• Rock climbing
• Soccer
• Singles Tennis
• Volleyball

The list was provided by the book “Fundamental Orthopedic Management for the Physical Therapist Assistant” by Robert C. Manske.

Is the Anterior Hip Replacement Approach Superior?

The choice of whether the anterior hip replacement approach is superior to other approaches, such as posterior or lateral, is a matter of ongoing debate and depends on several factors. Each approach has advantages and potential limitations, and what might be considered superior for one patient may not be the best choice for another.

The Surgery

According to Dr. Fernando, in his article “Direct Anterior Approach (Minimally Invasive) Total Hip Replacement,” he claims the anterior approach “results in quicker recovery, less pain, and more normal function after hip replacement. ”

In the anterior approach, the orthopedic surgeon can reach the ball and socket hip joint without detaching any tendons by moving muscles aside along their natural tissue planes. The procedure involves removing the ball and socket and then replacing it with an artificial one: metal, plastic, or ceramic. Since no hip muscles were cut, there are no hip precautions.

The posterior approach for a hip replacement involves making an incision in the back of the hip. Major muscles and tendons are being cut and require precautions:

• No hip flexion past 80 degrees to 90 degrees
• No hip adduction pas midline (past neutral)
• No internal rotation

The lateral approach for hip replacement involves making a cut on the side of the hip. The muscle mostly affected is the tensor fascia latae and the hip precautions are:

• Avoid hip flexion of more than 90 degrees
• No hip extension
• No hip extension with hip external rotation
• No combined motion of hip flexion, abduction, and external rotation

The Outcome

According to the American Association of Hip and Knee Surgery, there is insufficient evidence to suggest that one approach is superior. Joseph D. Maratt, MD stated, “There was no statistically significant difference in dislocation risk, fracture rate, blood loss, hematoma formation, length of hospital stay or readmission.”

Regardless of the approach, total hip replacement surgery has a success rate of 95%.

The Takeaway

The anterior surgical approach to a total hip replacement is relatively new, but it’s hard to say it is better. The best method depends on the individual patient’s needs and the surgeon’s expertise.

It’s essential to have a thorough discussion with your orthopedic surgeon to determine the best approach for your specific case. Your surgeon will consider your unique circumstances, anatomy, and surgical goals to make the most informed decision regarding the approach to use for your hip replacement.

Throughout my years as a PTA, I’ve only had two patients with an anterior approach. The majority of my hip patients had the traditional posterior approach. That said, the two patients with the anterior hip replacement had less pain and faster recovery.

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References

1. Moore , M. L., Brinkman, J. C., Pollock, J. R., Denkey, D. G., Makovicka, J. L., & Bingham, J. S. (2022, September 20). Patients are most interested in which hip … – arthroplasty Today. Patients are Most Interested in Which Hip Arthroplasty Approach? A 15-year Google Trends Analysis. https://www.arthroplastytoday.org/article/S2352-3441(22)00168-6/fulltext
2. Fernando, N.D. (no date) Direct anterior approach (minimally invasive) total hip replacement, Direct Anterior Approach (Minimally Invasive) Total Hip Replacement. Available at: https://orthop.washington.edu/patient-care/articles/hip/direct-anterior-approach-minimally-invasive-total-hip-replacement.html (Accessed: 11 October 2023).
3. Dreeben-Irimia, O. (2013) Physical therapy clinical handbook for PTAS. Burlington, MA: Jones & Bartlett Learning.
4. Manske, R.C. (2016) Fundamental Orthopedic management for the physical therapist assistant. St. Louis , MO: Elsevier.