The main difference between posterior and anterior approach hip replacement is the location of the surgical incision. The location of the incision determines which muscles will be cut or pushed aside during surgery. Posterior Hip Replacement surgery uses a curved incision on the side and back of the hip. The incision curves just behind the greater trochanter, the knobby bit of bone that sticks out at the side from the top of the femur (thigh bone).  

The posterior hip replacement approach requires surgeons to cut muscles and other soft tissue at the back of the hip, including:  The tensor fascia lata, which is a wide piece of fibrous soft tissue at the top of the outer thigh. It works with the iliotibial band (IT band) to help stabilize the hip and knee. The large gluteus maximus muscle, which is attached to the fascia lata. The gluteus maximus allows a person to extend and rotate the thigh outward. It also helps stabilize the pelvis and keep the body erect. The external rotators of the hip, which are small, short muscles that connect the top of the femur to the pelvis. These muscles provide hip stability, preventing the femur from dislocating out the back of the hip socket.

*Posterior Approach Hip Replacement Incision Location.

Posterior hip replacement is a minimally invasive hip surgery performed to replace the hip joint. It is also referred to as muscle sparing surgery because no muscles are cut to access the hip joint, enabling a quicker return to normal activity. The posterior approach is traditionally the most common approach used to perform total hip replacement.In posterior hip replacement, the surgeon makes the hip incision at the back of the hip close to the buttocks. The incision is placed so the abductor muscles, the major walking muscles, are not cut.

Posterior hip replacement surgery involves the following steps: The procedure is performed under general anesthesia. You will lie face down on a special operating table that enables the surgeon to perform the surgery from the back of the hip. An incision is made close to the buttocks beyond the abductor muscles. The surgeon detaches the muscles and tendons to gain access to the hip joint. Once the artificial components are fixed in place, the instruments are withdrawn, soft tissues are re-approximated, and the incisions are closed with sutures and covered with a sterile dressing.

The advantages of posterior approach for some surgical candidates include: a high success rate, minimally invasive incision, limited muscle damage, and the more precise placement of implants with excellent visibility of the joint.

During Posterior Hip Replacement, you will lie face down on a special operating table that enables the surgeon to perform the surgery from the back of the hip. An incision is made close to the buttocks beyond the abductor muscles.The surgeon detaches the muscles and tendons to gain access to the hip joint.Once the artificial components are fixed in place, the instruments are withdrawn, soft tissues are re-approximated, and the incisions are closed with sutures and covered with a sterile dressing.

Source: American Academy of Orthopaedic Surgeons, https://orthoinfo.aaos.org/; American Association of Hip and Knee Surgeons, https://hipknee.aahks.org/total-hip-replacement/; Arthritis-health, https://www.arthritis-health.com/