The hip joint is a connection point between your legs and torso. It’s made up of your thighbone (femur) and your hipbone (pelvis). The hip is a ball-and-socket joint that supports your body weight and allows you to move your upper leg. The hip and knee joints are the largest in the body.

The Hip Joint and How It Works

The head of your femur fits into a cup-shaped cavity (the acetabulum) in your pelvis. A flexible and tough protective tissue called cartilage covers the inside of the acetabulum and the head of the femur. Tissue lining your joint makes fluid that with the cartilage helps your bones slide easily against each other. Muscles and ligaments (strong fibrous tissues) hold the joint together.

The ball-and-socket joint lets your upper leg move at 3 degrees so you can do the following movements:

• Flex
• Extend
• Rotate
• Move back and forth
• Move in a circular motion

The most common reasons for damage to the joint or other tissues are:

• Hip strains: An injury or tear to the muscle tissue occurs.
• Bursitis: The fluid-filled sac in your joint has swelling.
• Hip dislocation: The thighbone pops out of the socket.
• Broken bones: An injury breaks or fractures one of the bones in or around your hip joint.

There are also medical conditions that can weaken your hip joint. This can put you at a higher risk of injury, pain or stiffness. Common conditions that affect your hip joint include:

• Osteoarthritis: This inflammation of your joints causes pain and swelling.
• Osteoporosis: This condition describing bone weakness may cause them to break easily.
• Hip dysplasia: Your thighbone doesn’t fit together in your pelvis as it should.

Anterior Approach Hip Replacement

If you have issues with your hip such as those above, your health care team may start with other treatments such as medication or physical therapy. If the pain or discomfort isn’t getting better, or it gets worse and interferes with daily life, hip replacement might be an option.

A total hip replacement is a type of surgery that replaces your hip joint with an artificial one. This surgery is also called hip arthroplasty. Surgeons can do these procedures from behind the hip, from the side of the hip or from in front of the hip. Total hip replacement with anterior approach refers to surgeries done from in front of the hip. These surgeries also may be called mini, modified, minimally invasive or muscle-sparing surgeries.

Using the anterior approach may allow your surgeon to do the surgery through a smaller incision (cut). The cut is in the front of the hip rather than in the side or back, like in traditional hip replacements. Having your surgery done this way may have other advantages. These are:

• Less muscle trauma
• Less pain
• Earlier and easier recovery
• Less limping
• Shorter hospital stay
• Decreased chance of hip dislocation

Total hip replacement with anterior approach is not an option for everyone. You may have other surgical choices, such as total hip resurfacing. Talk with your health care provider to see what makes sense for you.

Who Can Have an Anterior Hip Replacement?

Anterior hip replacement surgery is not for everyone. But if you meet the following guidelines, you might qualify:

• You are in generally good health.
• You maintain an average weight with less muscle mass and fat in the thigh area.
• Your hip condition has not been controlled well with other methods like medication or physical therapy.  
• You are mobile, active and independent before surgery.
• You have a good support network and a safe environment to recover following surgery.

Other factors that affect whether you should get this kind of surgery include:

• Prior hip surgeries
• Certain medical conditions
• Overall health

What to Expect Before, During and After Anterior Hip Replacement

Any surgery can feel a little overwhelming. Your Norton Orthopedic Institute team will walk you through everything you need to know from start to finish. Here is a general overview of what you can expect:

• You likely will get general anesthesia so that you can sleep through the surgery. If you get regional anesthesia, you also may get medicine to make you relaxed and sleepy.
• The care team will closely watch your heart rate, blood pressure and other vital signs before, during and after the operation.
• You may get antibiotics to help prevent infection.
• The skin around the surgical site will be cleaned. Any hair will be removed.
• The surgeon makes a cut in front of your hip joint. Then they separate your muscles to see your hip joint.
• The surgeon removes the upper part of your femur and the damaged cartilage and bone from your pelvis.
• The surgeon replaces your acetabulum and the head, neck and part of the shaft of your femur with an artificial joint.
• The surgeon may take an X-ray to make sure the joint is in the right place.
• The surgeon or an assistant will close up the incision.

After surgery, you will go to a recovery room to be watched while your anesthesia wears off. After your initial recovery, you will go to your hospital room. You should be able to start eating and drinking again slowly. You may need to wear stockings or plastic devices to help prevent blood pooling in your legs. You may be told how to do breathing exercises and coughing to help prevent pneumonia.

Your health care provider may decide to get an X-ray or another imaging test to look at your hip. You also may need tests to check your blood counts.

Your health care provider will tell you when it is OK to start moving around and when you can put weight on your leg. Depending on how you are feeling, you may go home the same day, or be kept in the hospital overnight.

You may be told what types of activities you can do and those you should avoid. As you start to get around, you may find that you need to use a cane or crutches. You also may need to work with a physical therapist to regain your mobility and strength. You should be able to do light activities within a couple of weeks. During this time, you may want to have extra help.

Keep all your follow-up appointments. Be sure to follow all your health care provider’s instructions. If you have external stitches or staples, you likely will have them removed about a week after your surgery.

Your artificial hip may wear out or loosen over time. Eventually, you may need another surgery. You may be able to extend the life of your implant by exercising regularly and taking precautions to avoid falls. You may need to take antibiotics before dental visits and minor surgical procedures. This can reduce the risk of infection to your new hip.

Care That’s Focused on You

• Minimally invasive procedures can have you home quickly with less pain and faster recovery.
• Sophisticated pain management aims to keep you comfortable and safe.
• We have a deep commitment to getting you moving again and managing your pain so you can keep up with your physical therapy.
• With 30 orthopedic locations in Louisville, Southern Indiana and surrounding communities, we have specialists near you.
• Communicate with your provider, manage appointments, refill prescriptions and more, anytime, from a computer or mobile device with a free MyNortonChart account.

Choose Norton Orthopedic Institute for Your Hip or Knee Replacement

• Same-day appointments are available with no referral required. When you’re ready to take care of the pain, you want to get started.
• Schedule your appointments online or call (502) 559-5500.
• Our fellowship-trained and board-certified orthopedic surgeons have the experience you can trust. They perform more than 800 hip replacements and 1,000 knee replacements every year.
• Robotic-assisted surgeries provide added precision when placing your new joint. This gives a more natural feel that more closely matches your unique anatomy. Minimally invasive techniques get you started on your recovery faster and often allow you to go home the same day as your surgery.
• Choose from 30 locations in Louisville and Southern Indiana for follow-up care.
• Norton Healthcare is the first health system in the nation to be recognized as an Advanced Orthopedic & Spine Center of Excellence by DNV.
• We help you get ready for surgery and through your recovery with educational programs available online and in person.
• Medicare, Medicaid and most major commercial insurance plans are accepted.
• Your free Norton MyChart account allows you to communicate with your provider, manage appointments, refill prescriptions and more from a mobile device or computer.