Hip Surgery Approach Preferences for Total Hip Arthroplasty (Anterior vs Posterior vs Lateral)

Hip replacement surgery has become one of the most successful and life-changing procedures in modern medicine. For people suffering from hip arthritis or long-term joint pain, it can mean a return to comfort, independence, and mobility.

A question many patients ask before surgery is:

“Which type of hip replacement approach is best — anterior, posterior, or lateral?”

The truth is, there’s no single approach that’s right for everyone. Each technique has its own benefits and challenges, and the decision depends on your body, your goals, and your surgeon’s expertise.

Understanding the Basics

A total hip replacement — also known as total hip arthroplasty (THA) — involves removing the damaged parts of your hip and replacing them with a smooth artificial joint, usually made from a combination of titanium, ceramic, or medical-grade plastic.

The goal is simple: to reduce pain, improve movement, and help you get back to the activities you enjoy.

What differs between approaches is how the surgeon accesses your hip joint.
Think of it as three different doorways — from the front, back, or side — all leading to the same place.

1. The Anterior Approach (Front of the Hip)

In this method, the incision is made at the front of the hip. The surgeon works between muscles instead of cutting through them, which helps preserve more of the body’s natural structure.

Main Benefits

• Less muscle damage, which can mean less pain and faster recovery in the first few weeks.
• Earlier mobility — many people walk unaided sooner.
• Lower chance of dislocation right after surgery in some patients.

Things to Know

• It’s not suitable for everyone, especially people with a very muscular build or past hip surgery.
• It can take longer to perform and may require special equipment.
• Some people notice mild numbness or tightness near the front of the thigh for a while after surgery.

Overall, the anterior approach offers a smooth early recovery, especially for patients who are active or eager to get moving quickly.

2. The Posterior Approach (Back of the Hip)

The posterior approach is the most traditional and widely used method around the world. The incision is made behind the hip joint, giving the surgeon a clear view and plenty of control.

Main Benefits

• Excellent visibility for accurate placement of the implant.
• A very reliable approach that works well for most body types and hip conditions.
• Decades of long-term success and consistent results.

Things to Know

• Early on, there can be a bit more stiffness or soreness compared to the anterior approach.
• In the past, it was thought to have a higher risk of dislocation, but with modern muscle-repair techniques, this is now very rare.
• Patients may need to avoid twisting or crossing their legs for a short time after surgery.

The posterior approach remains a strong, safe choice for most people, particularly when performed by an experienced surgeon.

3. The Lateral Approach (Side of the Hip)

This approach involves making the incision along the outer side of the hip. It’s less common today but still useful in certain situations.

Main Benefits

• Good visibility of the hip joint.
• Provides strong stability and is a good option for patients at higher risk of dislocation.

Things to Know

• Sometimes the small muscles on the side of the hip can be affected, causing temporary weakness or a limp during recovery.
• There’s a small chance of irritation to a nerve that runs near the area.
• Some studies show slightly higher rates of needing revision surgery compared to anterior or posterior approaches.

While less frequently used, the lateral approach remains an important option in selected cases, especially for people with specific bone structures or previous surgeries.

What the Research Shows

Studies comparing the three methods have shown that the long-term results are very similar.
All approaches provide excellent pain relief, improved movement, and a high quality of life when done properly.

People who have the anterior approach may walk more easily in the first few weeks, while those who have the posterior or lateral approaches often catch up within a few months. By three to six months, most patients can’t tell the difference in their recovery, strength, or comfort.

What matters most is the surgeon’s experience with the chosen method. A surgeon who performs a particular approach regularly will achieve smoother, more predictable results.

Recovery and Getting Back on Your Feet

No matter which approach is used, recovery follows a similar pattern. Most people can:

• Start walking with a walker or crutches within a day or two after surgery.
• Go home within three to five days.
• Begin gentle exercises or physiotherapy almost immediately.
• Resume driving and normal daily activities within four to six weeks.

Complete healing takes several months, but most patients are back to comfortable movement and normal routines by around three months. With continued strengthening and balance exercises, you can expect to enjoy your new hip for many years — often two decades or more.

How to Choose the Best Option for You

When planning your hip replacement, your surgeon will consider:

• Your anatomy – body shape, bone structure, and muscle condition.
• Your health and age – medical conditions, weight, or prior surgeries.
• Your lifestyle and goals – whether you want to return to sports, work, or simply walk without pain.
• Their own expertise – surgeons tend to specialise in the approach they know best, which ensures precision and safety.

You should feel comfortable asking your surgeon questions such as:

• How many hip replacements do you perform each year?
• Which approach do you recommend for me, and why?
• What will recovery look like in my case?
• What precautions will I need to follow after surgery?

All three surgical approaches — anterior, posterior, and lateral — can deliver excellent results. The differences between them are mostly in the early recovery phase, not in long-term success.

The most important thing is to work with a skilled, experienced orthopaedic surgeon who understands your needs, explains your options clearly, and supports you through recovery.

Modern hip replacements are highly durable, allowing patients to live active, pain-free lives for decades. Whether the surgeon goes in from the front, back, or side, the goal is the same — to help you move comfortably and confidently again.

This article “Hip Surgery Approach Preferences for Total Hip Arthroplasty (Anterior vs Posterior vs Lateral)”  does not provide medical advice and is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Please consult a doctor for all medical advice.

Sources:

https://orthoinfo.aaos.org/

https://www.hss.edu/

https://pmc.ncbi.nlm.nih.gov/