Best approach for hip replacement

I have the same question.
I am scheduled to have a hip replacement in 6 months. My dr ( who did my knee,on the same side) four years ago, only performs the posterior approach. Just wondering the pros and cons of having posterior as opposed to anterior. Any experience would be appreciated!

I had a hip replacement about 11 years ago. My Doc too only did posterior. I read a lot before having the surgery, and knew of other folks who were having it around the same time. What I read indicated that posterior took longer time to heal, but had fewer complications. Anterior had more complications but took less time to heal. Three of us in rehab had the surgery around the same time. The other 2 had anterior. I had no complications. They did. Now, this is a very small "study" 😊, and it was 11 years ago. Things have changed so much since then! Check the research, then decide. I may need to have it on my other hip at some point, and I personally will go with the one that has less complications, if in fact there is still a difference. All the best to you!

I had the anterior surgery 3 years ago and still have leg numbness and tingling in the thigh and down the leg to the foot. I know they says there's less chance of dislocation, but living with this is tiring. The nerves in the front are cut and, if they recover, it takes years. I also have L5-S1 spondylolisthesis and when my low back aches, that affects the leg as well. I'm just finishing PT for problems walking, stumbling, etc. and things are better but wish I hadn't done the anterior approach. i'm on a Mayo Clinic blog and people say the same thing and have heard this approach isn't being done as much. Good luck.

Hi Daisy. How do I find that discussion? Am I in the right place?

Hi I had my right hip replaced and it was the best thing done now I’m waiting for spinal surgery to fix compression of my lumbar stenosis this year then next year I’ll have to have my cervical stenosis operation , hopefully then I’ll be fixed and able to live life with minimal pain

Where do you doctor? The doctors at Allina won't fix my spine yet it's
entirely herniated and bulging with spondylolisthesis. Help

I have had both hips replaced due to avascular necrosis (etiology unknown). The right hip was replaced in 2013 by anterior approach. I was immediately relieved of the groin and leg pain I had and recovering from the surgery pain was surprisingly easy. At 4 weeks post-surgery I flew with my 11-year old grandson to Tennessee and enjoyed visiting zoos, museums, Lookout Mountain, and did much walking in other places. I took no pain medications after the first week. I was 66 years old. I do have femoral nerve damage with numbness and sensitivity in my thigh, but I'm used to that, and it is not a problem.
Three years later, the left hip was gone, and I had it replaced by another surgeon who preferred the posterior approach using robot assistance. I was living in another state and also caring for my 95-year-old mother. The post-surgery pain was greater than the first hip and the inconvenience of following the "rules" for avoiding dislocation were annoying but not problematic. I recovered well otherwise. I have no numbness in my left thigh due to nerve damage. By 6 weeks post-surgery I again flew to care for one of my daughters who had just had hip surgery as well. No problem with travel or the activity needed to care for another.
I did exercises to strengthen my quads and calves and lateral muscles before surgery (look online for exercises to do before hip surgery) and then had PT for 6 weeks afterwards. It's amazing how quickly the recovery went.
Both hips are still working fine, and it has made a huge difference in my life! If you need it, get it!
I am now 6 months post TKR on my right knee and recovery is so different from THR. I had 3 months of pre-hab with a PT which was enormously helpful and have had a fairly quick recovery. I'm now 77 and not as "spry" as I was at 66. The recovery for achieving functional bending and straightening is hard and painful. It requires determination and patience. I had a minimally invasive approach with no robot assistance. The tourniquet that is used caused a lot of swelling, bruising, and blistering but finally resolved. Now I am not even aware that my knee is different (at least most of the time). The pain and instability that I had prior to surgery is gone.
Both my mother and my mother-in-law needed help with mobility (wheelchair) in their final years because their knees were so bad. I didn't want that to happen to me. Don't wait too long to get surgery if you need it.

Also when I am finished will have had 3 maybe 4 operations with the knees and hips. You are right about having it done now( I am 72). I do not want to spend my last years in a wheelchair either!
Thanks for sharing!

one doesn't cut through muscles. that one would be better

Thanks Peter. I'm glad your hip replacement went so well. I've had both knees replaced, with terrific results, and I'll get my right hip replaced in June 2025.

As far as your lumbar and cervical spine - are you getting fusion, or something less intrusive? 10 years ago I had laminotomies at S1, L5, and L4 - a hole was drilled in those vertebrae to make more room for the sciatic nerve and relieve some of the pressure caused by stenosis and scoliosis. So far so good. I also maintain a very strong set of core muscles, and my surgeon tells me this is the best thing I can do for my spine (to avoid fusion).

As for anterior v posterior hip replacement, my understanding is that with a posterior incision the gluteus muscles have to be cut to get to the hip. Apparently these aren't minor cuts, and it increases post-op pain and takes longer to recover (or so I'm told).

With the anterior incision, the muscles are pulled apart to reach the hip. Someone mentioned that nerves were cut. I don't think this is ever intentional, but can happen in just about any surgery. My opinion is that anterior is better. I'll find out.

Surgeons choose a posterior incision for two reasons - 1) the surgeon simply doesn't have experience with the anterior approach, and/or 2) the patient may be carrying a lot of weight in the torso/belly and it's not viable to go the anterior route.