X-rays indicate I need a total hip replacement. Surgery options are lateral, from the side, or anterior. Which is best and why?
There is no best approach for total hip replacement. All approaches if done well can lead to excellent results.
In fact all approaches today use modern techniques such as small incisions, minimal bleeding and specialized instruments to allow adequate exposure for the procedure with minimal soft tissue damage compared to incisions used years ago.
The so called lateral, or anterolateral approach detaches a small piece of hip muscle which must be repaired. Occasionally this results in a slight limp post op while the muscle heals but usually leads to complete recovery without restrictions.
The true anterior or direct approach has recently become more popular with joint surgeons. It works between muscle groups which facilitates quicker muscle recovery. Sometimes but not always a special table is needed to make exposure easier. Inserting a femoral component or stem can sometimes be technically more difficult. For a surgeon experienced with the anterior approach this is usually not a problem. The scar with an anterior approach may be more cosmetic but there is also a small risk of a superficial nerve injury simply based on anatomy.
Bottom line is that there is no study to date that shows one is better than the other. However experienced surgeons that have used the anterior and lateral approach feel that anterior patients mobilize slightly faster.
Remember that the most important goal of any hip replacement is to achieve a long lasting well done implant that relieves pain without complication. This can be achieved with either approach.
My best advice is to pick your surgeon not the approach. Find one that you trust and trust him or her to pick the best approach for your hip replacement.