8 6 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • F E B R U A R U Y 2 0 1 8
There's been a lot of
debate surrounding
the positioning of
the patient during
total hip procedures;
many surgeons
claim the anterior
approach is superior
because it results in
easier surgery and
quicker healing
times. However, I'm
not so sure that's
the case. It's more
about how surgeons
handle the muscle, not the position that the patient is in, that
affects their recovery.
When I and other surgeons started doing the anterior approach,
we learned a crucial lesson: Split, don't cut, the fascia latae mus-
cle. At our center, we applied split-rather-than-cut to a posterior
approach. We found very little difference in recovery time between
posterior and anterior approaches. I often tell patients that they
can expect to feel 95% normal within 4-6 weeks.
More medical professionals are coming to a similar conclusion:
There's not a significant difference in improvement of gait param-
eters when a total hip procedure is done with the direct anterior
approach versus the posterior approach.
PATIENT POSITION
Anterior or Posterior Approach?
• MUSCLE MEMORY Splitting instead of cutting the fascia latae muscle affects
patient recovery more so than whether the patient is in the anterior or posterior
position during surgery.
Pamela
Bevelhymer,
RN,
BSN,
CNOR
