CALL NOW FOR AN APPOINTMENT 425.656.5060

Online Appointment Requests

For convenient scheduling, request an appointment online.

Direct Anterior Approach Total Hip Replacement Follow-Up Studies

By William P. Barrett, MD on

In the January 18, 2017 issue of the Journal of Bone and Joint Surgery, Dr. Michael Meneghini and coauthors reported on revision rates following different surgical approaches to hip replacement. They found that patients who had undergone a direct anterior approach, particularly early in the learning curve for a particular surgeon, had a higher risk of revision of the femoral component when compared to a lateral or a posterior approach. The authors noted that the posterior approach was associated with a higher rate of revision for dislocation. They also noted that acetabular or socket loosening was higher with a posterior approach when compared to an anterior approach. While the surgeons in this series found a higher rate of revision of the femoral component with an anterior approach, that has not been the experience we have found.

We published our results in the 2013 Journal of Arthroplasty where we compared direct anterior approach hip replacement to posterior approach hip replacement. We found a faster recovery, reduced pain and a quicker return to work, and this difference was significant up until the three month mark after surgery. At 6 months, there did not appear to be a difference between an anterior and posterior approach. We have now followed these patients out for a minimum of five years and have found no significant change in our results. There has not been any revision of the anterior approach patients over the first 5 years. There have been no femoral loosening or revision for fracture. We are in the process of putting together our data for publication later this year.

To summarize, in our experience and the experience of many others, the anterior approach is associated with less pain, a lower dislocation rate, shorter hospital stay and more accurate placement of the implants. Upon further follow-up, there has been no deterioration of our results with the anterior approach out to five years. We continue to be proponents of this approach for hip replacement. There is definitely a learning curve that varies from surgeon to surgeon but probably is in the range of 50 cases. We have now done over 1800 direct anterior approaches and find it to be a gratifying approach to total hip replacement.

LOCATIONS

RENTON

4011 Talbot Rd S #300
Renton, WA 98055

Phone: 425.656.5060
Fax: 425.656.5047

COVINGTON

27005 168th Pl SE #201
Covington, WA 98042

Phone: 253.630.3660
Fax: 253.631.1591

Maple Valley

24060 SE Kent Kangley Rd,
Maple Valley, WA 98038

Phone: 425.358.7708
Fax: 425.656.5047

Latest POA News

  • Free Hip and Knee Replacement Seminar, May 11

    Questions about hip or knee pain and what your options are? We’re excited to invite you to Dr. William Barrett’s free hip and knee replacement seminar on May 11th at 6 PM in the Medical Arts Center. Learn more about the benefits of joint replacement surgery and how it can help return you to an active, pain-free life. Dr. William Barrett is …

  • Join Us in the Walk to Cure Arthritis, May 20

    Did you know that arthritis is the #1 cause of disability in the United States, affecting more than 50 million people? Our friends at The Arthritis Foundation are committed to finding a cure for the millions of people who suffer from arthritis pain, including 300,000 children and their families. We are absolutely thrilled to be …

  • The Seattle Thunderbirds are on Fire!

    The ShoWare Center was exploding with excitement this past week as the Seattle Thunderbirds swept the Everett Silvertips 4-0 and are now boasting an impressive 8-0 in the 2017 WHL Western Conference Playoffs! We couldn’t be more proud to be supporting the Thunderbirds as their official team doctors. Helping these players stay healthy and in …

Dr. Barrett's Blog

  • Free Hip and Knee Replacement Seminar, May 11

    Questions about hip or knee pain and what your options are? We’re excited to invite you to Dr. William Barrett’s free hip and knee replacement seminar on May 11th at 6 PM in the Medical Arts Center. Learn more about the benefits of joint replacement surgery and how it can help return you to an active, pain-free life. Dr. William Barrett is …

  • Smoking and the Risk of Infection After Total Hip and Knee Replacement Surgery

    In a study by Tischler, et al, from the Rothman Institute in Philadelphia, Pennsylvania, patients who were active smokers were found to have a significantly increased risk for infectious complications following hip and knee replacement surgery. In this study, published in The Journal of Bone and Joint Surgery on February 15, 2017, the researchers looked at …

  • Even Patients Who Live Alone Can Be Discharged Home After Joint Replacement Surgery

    In a study presented at the 2017 annual meeting of the American Academy of Orthopedic Surgeons, surgeons from the Rothman Institute in Philadelphia, Pennsylvania, presented the results of a study examining 769 patients who underwent primary total hip or knee replacement surgery. Of this group, 138 patients lived alone. The surgeons found that patients who …