Total hip replacement involves replacing both the proximal femur and the acetabulum (hip socket). The anterior approach to total hip replacement at our Phoenix-area practice utilizes a natural interval between muscles and does not remove tendons or muscles from either the pelvis or femur. This approach is facilitated with the use of the Pro-Fx table designed specifically with this procedure in mind.
The traditional posterior approach to the hip requires removal of tendon and muscles from the bone. This destabilizes the hip and requires adherence to hip precautions after surgery that effect the way you sit, stand, use the bathroom and sleep. With the anterior approach, no hip precautions are necessary and dislocation rates are reduced. Other advantages of the anterior approach include decreased postoperative pain and quicker recovery. Use of an x-ray intra-operatively, which is not possible with traditional approaches, allows the surgeon to more accurately control leg length and make small changes during the operation.
Dr. Brian Miller is one of only two orthopaedic surgeons in Arizona who has fellowship training in the anterior approach to total hip replacement. He has been trained in all three approaches to performing total hip replacements and has chosen the anterior approach because he has seen firsthand its advantages. His experience and training with pelvic and acetabulum fractures, considered by many the most challenging fractures to treat, gives him a comprehensive understanding of the anatomy and workings of the hip joint.
Dr. Gil Ortega performed his first anterior hip replacement in 2002. He learned the anterior hip approach techniques while training at Yale under a pioneer of the approach, Dr. Kristaps Keggi. In the late 1970s,, Dr. Keggi was the first in the United States to present and publish his results using the anterior hip approach for total hip replacements. Dr. Ortega values the mentorship he shares with Dr. Keggi. Although experienced in all approaches to the hip, Dr. Ortega prefers to use the anterior approach for his partial and total hip replacements as he has recognized improved patient outcomes using the anterior approach.