What Is a Posterior Hip Replacement?

Mary McMahon

A posterior hip replacement is a surgical procedure to replace a damaged hip joint where the surgeon enters through a small incision at the rear of the hip. This approach is a departure from the traditional method, which involves a long incision accompanied by significant muscle and tendon damage. Patients who receive posterior hip replacements typically experience less muscle and tendon disruption, which shortens healing time and reduces the risk of complications. They also tend to develop less post-surgical pain, which can also improve outcomes in addition to keeping patients more comfortable.

Surgeons may recommend hip replacement when the hip joint is extremely damaged because of arthritis or other conditions.
Surgeons may recommend hip replacement when the hip joint is extremely damaged because of arthritis or other conditions.

Surgeons may recommend hip replacement when the hip joint is extremely damaged because of arthritis or other conditions. In this procedure, the head of the hip bone is replaced with a prosthesis to articulate smoothly with the pelvis. It can improve range of motion, reduce the risk of falls, and limit pain around the hip joint. Several surgical techniques are available and the surgeon may discuss them with the patient to determine the most appropriate option.

An X-ray of the pelvic area, showing a replacement hip.
An X-ray of the pelvic area, showing a replacement hip.

In this procedure, the surgeon enters the hip through the gluteus, the muscle covering the buttocks. The surgeon carefully separates the muscle, rather than cutting through it, limiting damage to tendons and ligaments. Once the hip is opened, the prosthesis can be set in place and secured, and the surgeon can close the incision. Posterior hip replacement still involves some damage to the muscles, including those used for vertical stability, and special precautions may be needed after surgery.

Historically, the risk of dislocations after surgery was higher with posterior hip replacement. Changes both to surgical technique and the prostheses used have changed this, but patients do need to exercise some care. They may need to limit their motions immediately after surgery to give the muscles a chance to recover. It is also important to control pain after a posterior hip replacement, both to keep patients comfortable and to limit damage to the incision site and surrounding structures that may be caused by pain-related tension.

Patients may be good candidates for this procedure if their hip replacements are suited to a posterior approach. The surgeon may want to examine medical imaging studies to determine the precise type of hip replacement needed and the best angle of approach. In some cases, another technique may be advised. There is also a potential risk that complications during surgery might force the surgeon to adapt. A planned posterior hip replacement could turn into a more invasive procedure as a result of bleeding, damage that wasn’t identified on scans, and other issues that may arise in the operating room.

A posterior hip replacement usually results in less post-surgical pain than traditional techniques.
A posterior hip replacement usually results in less post-surgical pain than traditional techniques.

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