Hip replacement surgery can feel overwhelming at first. If you’ve been told you may need a hip replacement, you’ve probably run into a flood of confusing terms online: total hip arthroplasty, anterior approach, posterior approach, hip resurfacing, and more. This guide breaks down what hip replacement actually is, what your options are, and what matters most to your long-term outcome.
What Is Hip Replacement Surgery?
Hip replacement is a highly effective procedure for treating advanced degenerative hip diseases, such as arthritis and osteonecrosis. During the surgery, the damaged ball-and-socket joint is removed and replaced with smooth, durable implants. The goal is simple:
- Remove the painful, degenerated surfaces
- Restore normal hip biomechanics
- Eliminate pain
- Allow you to return to the activities you love
You may hear different names for the same surgery: hip replacement, total hip arthroplasty (THA) or hip resurfacing (a different procedure, but often mistakenly grouped in). Partial hip replacement, or “hemiarthroplasty” is used in very low-demand, elderly patients, who suffer a certain kind of hip fracture. Regardless of the terminology, the fundamentals of hip replacement are the same.
What Does Hip Replacement Surgery Actually Do?
Hip replacement surgery is a procedure that replaces the worn or damaged parts of the hip joint with smooth, durable implants. The hip is a ball-and-socket joint, and when arthritis wears away the cartilage, the joint can become painful, stiff, and difficult to move. This leads to the bone-on-bone pain many patients feel with everyday activities like walking, standing, or getting dressed.
During hip replacement, the surgeon removes the arthritic ball at the top of the thigh bone and resurfaces the socket in the pelvis. These surfaces are replaced with carefully sized titanium, ceramic, and plastic components designed to restore motion, stability, and comfort.
Anterior vs Posterior Hip Replacement Surgery: Why the Names Cause Confusion
Online, the posterior and anterior approaches can sound like entirely different surgeries, which understandably creates confusion. What differs is simply the surgical pathway: the “front door” (anterior) or “back door” (posterior) of the hip. Within each category, there are multiple technical variations, often referred to by different names. These terms describe how the surgeon navigates muscles and soft tissues, whether specialized tables or positioning are used, and how exposure is optimized. The differing names do not change the fundamental operation or its purpose.
Anterior-based approaches include the Hueter or Smith-Petersen approach, the Direct Anterior Approach (DAA), mini-anterior or micro-anterior techniques, Anterior Minimally Invasive Surgery (AMIS), the Rottinger variant, inguinal crease or “bikini” incision anterior approaches, and table-assisted anterior techniques.
Posterior-based approaches include the posterolateral approach (often referred to as the traditional posterior approach), mini-posterior variations, the Moore or Southern approaches, the Kocher-Langenbeck approach, as well as more tissue-preserving techniques such as SuperPATH, the Superior Approach, PATH, and the STAR (Superior Transverse Anatomic Reconstruction) approach.
Choosing the Right Hip Replacement Surgery Approach
While the names may differ, the most important factor is not the label of the approach, but how safely and accurately the hip is reconstructed for each individual patient. The best outcomes come from using an approach that allows precise implant positioning, restores normal biomechanics, and aligns with the surgeon’s expertise and the patient’s anatomy and goals. Pros and cons of anterior-based vs. posterior-based approaches can be found here.
If you’re exploring hip replacement, talk with your orthopedic specialist to determine the right approach for you.
