Total Hip Replacement – Posterior Approach
The posterior approach has been the favoured approach for Australian Orthopaedic surgeons for many years and in many cases with good reason.
It is a versatile approach that allows good access to the hip joint, especially in complex or revision cases.
The patient is positioned on their side and the incision runs lengthways up the side of their hip and buttock. The big muscle of the buttocks – the gluteus maximus – is split and the deep hip muscles are divided off the bone and repaired at the end of the case.
As with all hip replacement procedures, a new acetabular cup is inserted into the pelvis (the socket) and the top of the femur (the ball) is removed and a new femoral stem is inserted into the femur bone. A metal or ceramic head is placed on the stem which fits into the plastic or ceramic socket.
Computer Assisted Surgery (CAS)
Dr Negus uses computer assisted surgery with the posterior approach to place the new acetabular cup as accurately as possible. This can be in the form of computer navigation, navigation with robotic placement or an individualised positioning system based on the patient’s scans. These methods help to place the components precisely in the bone though the posterior approach.
Most surgeons don’t use any computer guidance to place their implants. Navigation has been shown to make a difference in helping the surgeon to more accurately achieve the target position of the implants.
It usually takes between 70 to 90 minutes to perform a hip replacement using the posterior approach.
Which Approach is best for me?
Many patients now come to a consultation requesting particular approach based upon their own research and the experiences of family and friends. While this is totally understandable and every attempt is made to accommodate each patient’s wishes, the decision over which approach to use for hip replacement surgery relies on a number of clinical and technical factors. Therefore, Dr Negus will discuss the available options for each patient on a case-by case basis. You will have every opportunity to ask as many questions as you need before we come to an agreement on your treatment course.