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What is Direct Superior Hip Replacement?

Direct superior hip replacement is a minimally invasive surgery that provides your surgeon access to the hip joint with minimum displacement or damage to the surrounding muscles, tendons, and ligaments.

Indications for Hip Replacement

Hip replacement may be indicated to treat conditions such as arthritis, avascular necrosis and childhood hip disease. Surgery is suggested when:

  • Related hip pain limits daily activities
  • Pain persists even at rest
  • Hip stiffness limits your ability to move or lift your leg
  • Nonsurgical treatments such as anti-inflammatory drugs, walking supports or physical therapy fail to relieve pain 

Potential Benefits of Direct Superior Hip Replacement

The potential benefits of the direct superior hip replacement are:
Muscle Sparing: Direct superior hip replacement surgery avoids cutting key muscles such as the iliotibial band and some of the external rotator muscles. These muscles play an important role in performing everyday activities such as walking and bending.
Smaller Surgical Incision: Direct superior hip replacement can be performed through a 3- to-6-inch surgical incision, which is much smaller than the 10-to-12-inch surgical incision required to perform a traditional hip replacement surgery.
Less Infection Risk: As the incision size is much smaller, there is less risk of hip infection following surgery. 
Excellent Stability: Due to minimal damage to surrounding musculature, there is better support and stability for the newly replaced hip joint.
Faster Recovery: As key muscle groups are not disrupted during the surgery, there is an increased likelihood of a faster recovery with less pain and a quicker return to activities of daily living. 

Preoperative Preparation for Direct Superior Hip Replacement

Your doctor may design certain exercises to perform before the surgery to help strengthen the muscles that support your hip joint. A complete physical examination and lab tests will be conducted. You must inform your doctor about regular medications that you are on, as they may have to be stopped a few days prior to the surgery. 

Procedure for Direct Superior Hip Replacement

The surgery is performed with you lying on their side. A small incision is made on the posterior side of your hip. Access is gained to the hip joint through the muscles in your buttocks without disrupting the iliotibial band and other important muscles. The damaged tissue is removed, the surgical site is prepared for the implant and the implant is then placed.

Postoperative Precautions after Direct Superior Hip Replacement

Immediately after the surgery you will be prescribed pain medication to keep you comfortable. You will be encouraged to start weight-bearing, walking with support, and participating in physical therapy as soon as possible to prevent joint stiffness and optimize joint function. The direct superior hip replacement does not require too many postoperative precautions as the risk of hip dislocation with normal activities after this surgery is very low.

Risks Associated with Direct Superior Hip Replacement

The direct superior hip replacement surgery is a very safe procedure; however, as with any surgery, there is a minimal risk of complications such as 

  • Infection 
  • Bleeding 
  • Delayed healing
  • Implant loosening

  • American Association of Hip and Knee Surgeons
  • Cleveland Clinic
  • American Academy of Orthopaedic Surgeons
  • Alpha Omega Alpha
  • Gold Foundation
  • Steward Orthopedic & Sports Medicine Center
  • UNIVERSITY OF LOUISVILLE