Hips can be replaced from the posterior approach or through an anterior approach. New instruments and a specialized table make the anterior approach easier. The Anterior approach uses a muscle and tendon sparing approach. This means that no tendons are cut, no muscles are split and the recovery is quite rapid. My patients leave the day after surgery using a cane only. Hospital bills are less also. One can do this surgery without the specialized table as well. Many doctors poo poo the anterior approach vs. the posterior. I will say, I myself, was surprised at how much better patients feel after surgery when done from the front. The surgery does take a little bit more time and technically may be a bit more difficult but it is well worth it.
Whether one uses the Hana table or not may not make a huge difference in the end. It acts like a second assistant and can be handy. However, the mechanical nature of the table does take away some of the tactile feel we get without its assistance. Currently, I do almost all total hips through the anterior approach. This does not mean, though, that I might not offer the posterior to someone depending on their BMI size or other physical factors.
