Patients have been asking us about an article recently published in Forbes Magazine about hip replacement surgery using the anterior approach.


Chronic hip pain doesn’t have to mean an end to doing the things you love to do.

Chronic hip pain—often caused by a condition such as arthritis or a physiological irregularity—used to mean limited mobility and perhaps the use of a cane, walker or wheelchair later in life. The first modern surgical intervention technique to treat hip joint pain occurred in the early 1960’s, when Sir John Charnley of the Manchester Royal Infirmary, designed a low friction arthroplasty that became the blueprint for modern hip replacement surgery. Charnley’s design allowed surgeons to replace a poorly-functioning human hip joint with a manmade femoral stem, acetabular component and acrylic bone cement. The result is an artificial extension of the patient’s femoral bone that attaches to the hip socket.

Several different surgical techniques have been developed to replace the hip joint with prosthesis. One popular technique, known as the posterior approach, involves making an 8-10 inch incision next to the hip, splitting the gluteus muscle, and cutting muscles connected to the top of the femur. Many surgeons have relied upon this technique as it provides an excellent view of the patient’s hip joint.

A newer technique, the anterior approach, involves making a much smaller incision (generally one to two cuts ranging from 2-5 inches long). Proponents of the anterior approach favor it over other techniques: smaller incisions reduce blood loss, result in less pain, shorter hospital stays and faster healing times as well as NO dislocation precautions. No muscle cutting is required with the anterior approach.

“I started performing anterior hip replacements in 2006,” said Dr. Michael Bollinger, an orthopaedic surgeon at Sebastopol Orthopaedics. “At that time, I wasn’t aware of any other surgeons in Northern California doing them. There’s nothing wrong with the older techniques, but in my experience, patients who have the [anterior approach] procedure are up and walking the same day, with less pain. They also heal more quickly and start resuming activities they haven’t done in years since their pain started.”

The biggest barrier Bollinger sees to eliminating hip pain isn’t surgery, but rather the patient’s hesitancy to deal with the problem.

“People live with intense pain for a long time,” said Bollinger. “No one wants to rush into major surgery, but I see patients who have suffered for years from pain caused by bone-on-bone arthritis. They stop doing the things they love and just walking around becomes a huge challenge. More often than not, once they’ve had the surgery, they’re amazed that the pain just disappears. Most of our patients are able to get back to their normal activities within weeks of the surgery.”

If you’re experiencing hip pain or have questions about anterior hip replacement surgery, please contact our office at 707.823.7602 to schedule an appointment to be seen.