Total Hip Replacement

Anterior Total Hip Replacement

Anterior Total Hip Replacement or a Total hip Replacement through the Anterior Approach is a newer way to perform a total hip replacement.

Anterior means Front. Posterior means Back. So the Anterior Approach to the Hip is from the front of the hip joint.

For many years we have been performing total hip replacements through the posterior approach which involves a cut at the back of the hip joint and cutting the muscles to access the hip and perform the hip replacement. The down side to this approach has always been a risk of dislocation of the newly replaced hip. Thankfully this has become a low risk but is still always present with this approach.

Anterior Total Hip Replacement or a Total hip Replacement through the Anterior Approach performs the same Total Hip Replacement but through a different approach, from the front.

In an Anterior Total Hip Replacement a small, usually 8-12cm incision is performed at the front of the hip just in front of the protruding outer part of the hip (trochanter). A careful dissection to the muscles is performed. In this approach the muscles are not cut but we approach BETWEEN the muscles and come down to the hip from in front rather than behind. The same bone cuts are made and the Arthritic joint is replaced with metal and ceramic components.

The advantages of the Anterior Approach for a Total hip Replacement are that we do not cut muscles but go between them. There also seems to be a lower dislocation rate of Total Hip Replacements performed through the anterior approach.

Whilst this approach is not for everyone it is now rare for Professor Papantoniou to perform a Total Hip Replacement with any other approach than the Anterior Approach to the Hip.

A/Professor Papantoniou treats disorders of the Adult Lumbar Spine.

At different stages in our lives various lumbar spine problems can occur.
In the young adult acute disc prolapses (slipped discs) can occur. These are often found in manual workers.
As we get older other problems can present themselves.
Arthritis can occur in the spine, as well as other parts of the skeleton. Facet joint arthritis or disc problems can lead to lower back pain or eventually spinal canal stenosis.
Instability of the lumbar spine can occur for various reasons from facet joint arthritis to pars interarticularis defects.

A/Professor Papantoniou treats these degenerative disorders of the Adult Lumbar Spine individually as is appropriate for each patient and their condition.

Often time and non-operartive measures such as diet, exercise, physiotherapy and cortisone (steroid) injections will be able to control the pain without requiring surgery.

Please follow the links for descriptions of the terms above and some of the procedures A/Professor Papantoniou offers. Lumbar disc prolapses (slipped discs) when a weakness of the disc occurs due to age, wear and tear or trauma such as a work injury the centre part of the disc (nucleus) or the thick rim of the disc can bulge out putting pressure on the nerve.

Facet joint arthritis

The facet joint is a small joint between two bones in the lumbar spine. It provides bony stability and with other structures such as ligaments stops one vertebra from slipping forward on the one below. Arthritis at these joints can lead to slipping of the vertebrae or if extra bone (osteophytes) grow as a result of the arthritis pressing on the nerve or canal stenosis.

Pars Interarticularis

The pars interarticularis (or pars) is a part of the vertebral arch. This is the bone at the back of the spine, behind the main vertebra and forms part of the arch over the back of the spinal cord. Defects of ths part of the bone can lead onto instability of the lumbar spine.

Minimal Pain Surgery ( MPS )

of the lumbar spine allows our patients to mobilse at 4 hours or earlier and eat and drink on return to the ward.

Percutaneous Lumbar Fusion

allows for smaller incisions for placement of pedicle screws in the Lumbar Spine. This minimises the trauma to the surrounding muscles.

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