Direct Anterior Total Hip
Dr. Hester performs total hip replacement using the Direct Anterior Approach — a minimally invasive technique that works between muscles rather than cutting through them, resulting in less pain, faster recovery, and more natural movement sooner after surgery. He is one of only a few surgeons in East Texas that performs the direct anterior approach and he is the ONLY surgeon in East Texas that performs the BIKINI incision anterior hip which is available to most patients upon request.
Minimally Traumatic + Advanced Technology = Optimal Results
Dr. Hester performs almost all (95% at least) hip replacements through what is called a direct anterior approach. There are essentially 3 ways to perform a hip replacement – posterior, lateral, and anterior. This refers to where the incision is located and what has to be done under the skin to access the hip. Through a lateral or posterior approach you have to dissect through and detach some of the large muscles of the lateral and posterior hip. This leads to significantly more trauma to the soft tissues and thus makes the initial recovery more difficult and more painful. In addition, it can destabilize the hip more than an anterior approach which can lead to a higher risk of a hip dislocation after surgery which is very painful and could lead to revision surgery.
Through the anterior approach, he goes between the major muscles groups to access the hip. He does not have to cut straight through any muscles or detach any major muscles. This tends to make the initial recovery less painful and easier than the other 2 approaches. Also, because there is less destabilization of major muscle groups, there is a lower rate of dislocation following surgery and therefore he will not place any movement restrictions on patients in most circumstances.
In addition to being the only surgeon in East Texas that offers the bikini incision anterior total hip, he is also the ONLY surgeon in East Texas that performs his anterior total hips without the use of a specialized traction table. While technology has advanced as well as surgical technique, the use of a traction table during total hip replacement has been known to increase the risk of fracturing the femur during surgery as well as causing nerve injuries, both of which can be a devastating issue in your early recovery after total hip replacement. He underwent special training in order to perform the anterior hip without the use of a traction table and has since performed well over 1,000 anterior hips using a standard OR table without the use of unnecessary traction and manipulation of the leg.
Bikini Incision Anterior Total Hip
The bikini incision anterior total hip is an alternative way to perform an anterior hip replacement. The benefit of it is that the skin incision itself follows the natural tension lines of the skin in that region and thus leads to better cosmesis and less wound healing complications. Underneath the skin, the approach between the muscles and the hip replacement itself is the same as the traditional anterior approach total hip. Here is an example of one of Dr. Hester's patients 2 months out after right anterior total hip using the bikini incision. It should be noted that not all patients are candidates for the bikini incision and it must be requested prior to scheduling so that he can discuss what is best for you. As already mentioned above, Dr. Hester does essentially ALL hip replacements through the anterior approach and just because you may not be a candidate for the cosmetically pleasing bikini incision you will still obtain the immense benefits of the anterior total hip replacement regardless.
