Anterior Approach to Total Hip Replacement

FAQs for Anterior Approach:

FAQs Answered by Alec E. Denes, M.D.

• When can I drive after hip replacement?

  Driving is safe once you are fully bearing weight on the new hip, and no longer taking any narcotic pain medications. This could be as early as 5-7 days after surgery. Make sure you try driving in a safe area first to test out your strength and mobility.

• What about having sex?

  Sexual intercourse may be resumed at any time as long as it is comfortable.

• When is it safe to travel?

  It is recommended to avoid any travel over 2 hours for the first 4 weeks following surgery. Major travel means extended sedentary periods, often in the pressurized cabin of an airplane, both of which increase the risk of blood clots.

• How long are the TED stockings needed?

  You may wear compression stockings to control swelling, if desired; but it is not required to wear them at all, unless otherwise instructed.  

• How soon can I swim or use a hot tub?

  You should wait four (4) weeks after surgery until you submerge the incision in a pool or hot tub. It is OK to shower normally 3 days after surgery.

• Do I need physical therapy?

  You will have physical therapy while in the hospital or at the surgery center.  This will be primarily directed at regaining household mobility and normal daily activity. Your main goal in the first few weeks should be the same.

  Because the anterior approach preserves the major muscles around the hip joint, extensive outpatient physical therapy after surgery is not necessary for most patients.  I do suggest doing 3-4 visits with a physical therapist starting 2 weeks after your surgery.

  What limitations will I have after hip replacement?

  You will have NO restrictions on hip motion. You may move and position your new hip however is comfortable. This is due to the anterior approach technique performed.

  I recommend waiting until 6 weeks post-surgery to resume regular gym exercise, or any sports. After that, you may return to low-impact aerobic exercise and any weight machines. I recommend avoiding any impact exercise (such as running or jumping) permanently to minimize the wear and tear on your new hip. You may return to hiking, biking, golf, swimming, skiing, horseback riding, etc. My goal is to get you back to an active lifestyle, so send me photos and/or stories of you enjoying your new hip!

• What type of implants do you use?

  The implants I currently use for most hip replacements are the Actis stems, and the Pinnacle cup. Both are products of DePuy Synthes, a subsidiary of Johnson & Johnson. These are titanium implants with a rough surface that bonds to the surrounding bone through a biologic "ingrowth" process, and no cement is used. The "bearing" surfaces are ceramic and polyethylene plastic.  I may use other components, including cemented implants, when needed for specific reasons.  I have never used the metal-on-metal implants that have been in the news due to being recalled..

• Is it normal to have numbness in my thigh after surgery?

  Some numbness surrounding the incision and upper thigh is expected after anterior approach hip replacement. This typically improves gradually over the first several months.

• Why does my thigh hurt after surgery?

  It is common to experience thigh soreness, swelling, and/or bruising. The bruising often does not peak until you are 1 week or more post-op, and may appear all the way down to or below your knee. It may take a month or two for the swelling and bruising to resolve.

  Your swelling and pain may increase if you are too active in the first few weeks after surgery. For that reason, it is best to take it easy for the first 2 weeks, practice the exercises from the hospital physical therapist, and practice walking. Remember to ice your hip after activity during the first 2 weeks after surgery. This will help control the pain and swelling.

• Are follow-up appointments needed after surgery?

  We will schedule follow-up appointments for you to come to the office for x-rays, an incision check, and for our team to check on your recovery progress after surgery.  These are typically at 2 weeks, and again at 6 weeks after your surgery.   These may be scheduled with Dr. Denes or with his PA, Danielle Kohl.  Additional follow-up appointments are scheduled at 1 year and every 5 yrs after surgery to repeat xrays.

• I need both hips replaced. Can you do both at once?

  It is possible to do both hip replacements during the same surgery, but this is only appropriate for younger, active, and healthy patients. I can discuss this with you personally, but typically I recommend doing the two surgeries separately, about six weeks apart.