If you’re considering hip replacement surgery, you might have heard of the anterior approach to hip surgery and the potential advantages it offers for patients who may be good candidates.
Unlike traditional posterior hip replacement surgery that uses a large incision on the back side (or posterior) of the hip, the anterior approach for total hip replacement uses an incision on the front of the hip, eliminating the need to cut through major muscle groups surrounding the joint. It’s this important difference that can help patients who are good candidates for the anterior approach to recover more quickly and with less discomfort compared to the posterior approach.
Proper placement of the incision is critical for enabling the surgeon to access the joint and accurately place the implant without damaging the surrounding muscles, and at Muve Lakeway, a special surgical table is utilized called a Hana® table to improve both accessibility and visibility throughout the procedure.
The Hana Table: How It Works
The Hana® table was designed specifically for use in anterior hip replacement procedures. The table features a normal padded upper portion to support your head and torso, but the lower half of the table features a special “split” design that enables each leg to be positioned independently of the other without the use of special external supports. Once you’re on the table, your legs are secured in place at your feet using special boots, leaving the rest of your leg “free.”
The leg supports – or spars – can be rotated, lifted and lowered, “opening up” the hip joint for better access during surgery. Ball joints at the top and bottom of the spar provide an infinite degree of movement, which means we can position your hip in precisely the best or optimal position for your surgery, based on your anatomy and other factors, then lock the spars in place so the hip is securely immobilized.
In addition to the rotational and “up-and-down” movements of the leg spars, the upper portion of the table can also be tilted so your torso is in a declining position (i.e., tilted toward the floor). Combined with the rotational aspects of the spars, this allows much better visualization and improved access to your femur throughout the surgery, making it easier for us to prepare the bones of the joint prior to placement of the implant. Additional attachments can be used to lift the femur, clearing it of the surrounding tissues to make it easier to place both the “cup” and “ball” portions of the prosthesis.
More Benefits of the Hana Table
Certainly, being able to position and even raise the femur into an optimal position is important for ensuring the implant placement is as precise and accurate as possible. But the table offers another advantage: The locking mechanism of the table’s support system helps keep the hip securely in one position without any risk of wobbling. That additional stability makes it much easier for us to focus on the task of restoring the joint and placing the implant, and it also helps reduce the time spent in hip surgery since less time is spent adjusting and supporting the joint’s position throughout the surgery.
The Hana® table can generally accommodate patients up to 6’9”, with a maximum inseam length of 43 inches, and it can also support the unique needs of overweight and very muscular patients. In the past, these patients haven’t always been considered ideal candidates for the anterior approach to total hip replacement because the amount and type of tissue surrounding their hip made accessing the joint more difficult. But because the Hana table can be adjusted in so many ways, it’s possible to provide greater visibility and access for these patients in some cases, thus enabling them to enjoy the same benefits of the anterior approach as their peers who may have a smaller frame or have average muscle tissue.
If you and your physician decide that anterior approach hip replacement surgery is right for you and that a Hana® table will be utilized, chances are, you’ll be well sedated by the time you’re placed on the table, so you probably won’t even see it on the day of your surgery. Still, it’s comforting to know your surgery will be performed taking full advantage of some of the more advanced technology available today so you can enjoy optimal results and long-term outcomes.
*Professional Services are provided by independent physicians and not by Muve Health.
This blog post is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.