Types of Hip Surgery

When an individual presents with hip pain and has failed to respond to conservative treatment, hip surgery may be warranted. 

Depending on each patient’s pathological condition and physical presentation there are several different types of hip surgery that could be utilized. Listed below are three types of hip surgery that are commonly being performed to treat orthopedic hip conditions.  If you would like to learn more about the hip, please go to Hip Anatomy Video

JOI Hip Anatomy PictureAnatomy of the Hip

The Types of Hip Surgery Are:

Hip replacement surgery is commonly performed to treat hip conditions such as severe osteoarthritis and hip fractures. In fact, over 300,000 total hip replacements are performed annually in the United States. 

When your hip has become extremely painful or stiff to the point where it is limiting your ability to complete normal daily activities, and the severity of hip damage does not allow for other, less invasive, surgical options, then a total hip arthroplasty can be a safe and effective operation to help decrease pain and restore hip function. 

The two main approaches to performing these surgeries include the anterior approach and the posterior approach.

Posterior approach:

This type of hip surgery involves the surgeon creating a 4-6 in (maybe larger for larger patients) incision along the outer buttock, the splitting of the gluteus maximus muscle, and the detaching (and later reattaching of the piriformis muscle and the superior gemeli muscle (2 hip rotator muscles). 

Types of hip surgery Image of Hip Surgery

The head of the femur is removed and a metal stem is placed in the hollow part of the femur, followed by the placement of a metal or ceramic ball on the top of the stem that acts as the new head of the femur. 

Then the acetabulum (socket) of the hip joint is removed and replaced with a new metal socket. A spacer is placed between these two parts that can be metal, plastic, or ceramic in order to decrease friction within the hip joint

Anterior approach:

With this type of hip replacement surgery the surgeon actually makes an incision on the front part of the upper thigh, and many times there is no need to cut through muscle. The removal of the damaged joint and then the addition of the implants is similar to the posterior approach. 

This approach may allow for an earlier return to activities and a significant decrease in the risk of dislocation, but it is also a more technically challenging surgery with higher risks of injury during surgery due to the position the patient must be in and the proximity of a large nerve near the area the incision should be performed.

Hip Preservation Surgery/Hip Arthroscopy

Hip arthroscopy is one type of hip surgery that may be performed when the hip joint damage is not severe enough to warrant a hip replacement, but the patients still have significant pain despite conservative management efforts. 

There are multiple reasons that hip arthroscopies are performed but one very common reason results from patients who present with extra bone formation on the femur (ball) and/or acetabulum (socket) of the hip which can lead to damage of the hip labrum which is a cartilaginous structure that comes off the socket of the hip and acts as a gasket to improve hip stability. 

During hip arthroscopy, a camera (arthroscope) is inserted into the hip joint through a very small incision. Once the problem is identified, other instruments are inserted into the hip joint through separate small incisions and are used to correct the problem (remove extra bone formation, remove loose bodies or inflamed tissue, remove damaged cartilage, or repair the labrum). 

This type of procedure is much less invasive than total hip replacements and usually lead to a much quicker recovery. However, occasionally the damage to the hip is too severe for this procedure to be successful.  Physical Therapy is needed for any of these surgical procedures.


By: Nichole Clayton, PT

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