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Osteoarthritis<\/strong>: The most common cause of hip arthritis, characterized by the wearing down of cartilage.<\/p>\n<\/li>\n
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Rheumatoid Arthritis<\/strong>: An autoimmune condition causing joint inflammation and degeneration.<\/p>\n<\/li>\n
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Hip Dysplasia<\/strong>: A condition where the acetabulum (hip socket) doesn’t form properly, leading to joint instability and wear.<\/p>\n<\/li>\n
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Avascular Necrosis<\/strong>: A condition where the blood supply to the femoral head is disrupted, leading to bone death.<\/p>\n<\/li>\n<\/ul>\n
![\"X-ray](\"https:\/\/2025divi.cortho.org\/wp-content\/uploads\/2021\/05\/Posterior-Hip-Replacement.jpg\" "\\"X-ray")
X-ray showing total hip replacement.<\/p><\/div>\n
How the Body Part Normally Works? (Relevant Anatomy)<\/h3>\n
The hip joint is a ball-and-socket joint consisting of the femoral head (ball) and the acetabulum (socket) in the pelvis. The articular cartilage covering these structures allows for smooth movement. When the cartilage wears down, typically due to arthritis, the bones begin to rub together, causing pain and stiffness.<\/p>\n
What You Might Feel \u2013 Symptoms (Clinical Presentation)<\/h3>\n
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Pain<\/strong>: Often in the groin or thigh, particularly when moving or bearing weight.<\/p>\n<\/li>\n
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Stiffness<\/strong>: Difficulty moving the hip, especially with bending or rotating the leg.<\/p>\n<\/li>\n
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Decreased Mobility<\/strong>: Limited ability to walk, climb stairs, or perform daily tasks.<\/p>\n<\/li>\n<\/ul>\n
How Doctors Find the Problem? (Diagnosis and Imaging)<\/h3>\n
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X-rays<\/strong>: To examine joint space narrowing and changes in bone structure.<\/p>\n<\/li>\n
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MRI or CT scan<\/strong>: Used to assess soft tissues and detect other issues like labral tears.<\/p>\n<\/li>\n
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Physical Exam<\/strong>: To assess range of motion and pain levels.<\/p>\n<\/li>\n<\/ul>\n
Procedure Types or Techniques (Classification)<\/h3>\n
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Posterior Approach<\/strong>: The most common method, involving an incision at the back of the hip.<\/p>\n<\/li>\n
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Anterior Approach<\/strong>: Accessing the joint from the front, offering benefits like quicker recovery.<\/p>\n<\/li>\n
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Lateral and Anterolateral Approaches<\/strong>: Less commonly used, involving incisions at the side of the hip.<\/p>\n<\/li>\n<\/ul>\n
![\"Intraoperative](\"https:\/\/2025divi.cortho.org\/wp-content\/uploads\/2021\/05\/Posterior-Hip-Replacement-2.jpg\" "\\"Intraoperative")
Intraoperative image showing posterior hip replacement.<\/p><\/div>\n
Other Problems That Can Feel Similar (Differential Diagnosis)<\/h3>\n
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Trochanteric Bursitis<\/strong>: Inflammation of the bursa near the hip.<\/p>\n<\/li>\n
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Sciatica<\/strong>: Nerve pain that radiates from the lower back to the hip and leg.<\/p>\n<\/li>\n
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Labral Tears<\/strong>: Tears in the cartilage around the hip socket.<\/p>\n<\/li>\n<\/ul>\n
Treatment Options<\/h3>\n
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Non-surgical<\/strong>: Medications, physical therapy, injections, and lifestyle modifications.<\/p>\n<\/li>\n
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Surgical<\/strong>: Posterior hip replacement or other surgical approaches, depending on the patient’s condition and anatomy.<\/p>\n<\/li>\n<\/ul>\n
Recovery and What to Expect After Surgery<\/h3>\n
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Immediate Post-op<\/strong>: Patients may start walking with assistance on the day following surgery, with weight-bearing supported by crutches.<\/p>\n<\/li>\n
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Physical Therapy<\/strong>: Begins shortly after surgery to restore mobility and strengthen the hip.<\/p>\n<\/li>\n
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Full Recovery<\/strong>: Most patients regain substantial function and independence within 6-12 weeks.<\/p>\n<\/li>\n<\/ul>\n
Possible Risks or Side Effects (Complications)<\/h3>\n
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Infection<\/strong>: A risk with any surgical procedure.<\/p>\n<\/li>\n
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Blood Clots<\/strong>: Deep vein thrombosis (DVT) can occur.<\/p>\n<\/li>\n
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Dislocation<\/strong>: The hip implant may dislocate if not properly positioned.<\/p>\n<\/li>\n
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Leg Length Discrepancy<\/strong>: A slight difference in leg length post-surgery.<\/p>\n<\/li>\n
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Fracture<\/strong>: Rare, but possible during or after surgery.<\/p>\n<\/li>\n<\/ul>\n
Long-Term Outlook (Prognosis)<\/h3>\n
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Success<\/strong>: Most patients experience significant pain relief and regain mobility after posterior hip replacement. The prosthetic hip joint typically lasts 15-20 years or more.<\/p>\n<\/li>\n
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Ongoing Care<\/strong>: Patients are advised to avoid high-impact activities to prolong the lifespan of the implant.<\/p>\n<\/li>\n<\/ul>\n
Out-of-Pocket Cost<\/h3>\n
Medicare<\/strong><\/p>\n
CPT Code 27130 \u2013 Posterior Hip Replacement (Total Hip Arthroplasty via the Posterior Approach): $303.45<\/p>\n
Medicare Part B typically covers 80% of the approved cost for this procedure once your annual deductible has been met, leaving you responsible for the remaining 20%. Supplemental Insurance plans such as Medigap, AARP, or Blue Cross Blue Shield generally cover that remaining 20%, minimizing or eliminating out-of-pocket expenses for Medicare-approved surgeries. These plans work alongside Medicare to fill the coverage gap and reduce patient financial responsibility.<\/p>\n
If you have Secondary Insurance, such as TRICARE, an Employer-Based Plan, or Veterans Health Administration coverage, it acts as a secondary payer. These plans generally cover any remaining balance, including coinsurance or small deductibles, which typically range from $100 to $300, depending on your plan and provider network.<\/p>\n
Workers\u2019 Compensation<\/strong><\/p>\n
If your posterior hip replacement is required due to a work-related injury or degenerative hip disease caused by your job, Workers\u2019 Compensation will cover all associated medical expenses, including surgery, rehabilitation, and follow-up care. You will not have any out-of-pocket expenses, as the employer\u2019s insurance carrier directly covers all approved treatments.<\/p>\n
No-Fault Insurance<\/strong><\/p>\n
If your hip replacement surgery is needed due to an automobile accident, No-Fault Insurance will typically cover the full cost of treatment, including surgery and postoperative care. The only potential out-of-pocket cost may be a small deductible or co-payment depending on your insurance policy.<\/p>\n
Example<\/p>\n
John Smith underwent posterior hip replacement (CPT 27130) due to severe hip arthritis. His estimated Medicare out-of-pocket cost was $303.45. Since John had supplemental insurance through Blue Cross Blue Shield, his remaining balance was fully covered, leaving him with no out-of-pocket expenses for the surgery.<\/p>\n
Frequently Asked Questions (FAQ)<\/h3>\n
Q. What is the recovery time for posterior hip replacement?<\/strong>
A. Recovery typically takes 6-12 weeks, with most patients returning to normal activities within 3 months.<\/p>\nQ. Can I drive after hip replacement?<\/strong>
A. Most patients can drive within 4-6 weeks, depending on the leg and recovery process.<\/p>\nQ. How long do hip implants last?<\/strong>
A. Hip implants typically last 15-20 years, though this may vary depending on activity level and other factors.<\/p>\nSummary and Takeaway<\/h3>\n
Posterior hip replacement is a proven and highly successful procedure for patients with hip arthritis or severe joint damage. It offers significant pain relief and functional improvement, although the recovery time can vary. The posterior approach remains the gold standard in hip replacement surgeries due to its reliable outcomes and good access to the hip joint.<\/p>\n
Clinical Insight & Recent Findings<\/h3>\n
A recent study compared the direct anterior approach (DAA) and the posterolateral approach (PLA) for total hip replacement in middle-aged and elderly patients with femoral neck fractures. Researchers found that the anterior approach led to shorter surgery times, smaller incisions, less blood loss, and faster postoperative recovery than the posterior method.<\/p>\n
Patients who underwent the DAA also reported lower pain levels and higher hip function scores in the first six months after surgery, though outcomes were similar at one year. Importantly, complication rates and implant alignment were comparable between the two approaches.<\/p>\n
Overall, the study concludes that the anterior approach offers clear short-term advantages in recovery speed and reduced surgical trauma, supporting its broader use in clinical practice. (“Study comparing anterior vs. posterior hip replacement outcomes \u2013 see PubMed.<\/em><\/a>“)<\/p>\n
Who Performs This Surgery? (Specialists and Team Involved)<\/h3>\n
Orthopedic surgeons specializing in joint replacement perform posterior hip replacement surgeries, assisted by anesthesiologists, surgical nurses, and physical therapists.<\/p>\n
When to See a Specialist?<\/h3>\n
If you experience persistent hip pain that affects your daily activities and non-surgical treatments have not helped, it may be time to consult an orthopedic surgeon.<\/p>\n
When to Go to the Emergency Room?<\/h3>\n
Seek immediate medical attention if you experience signs of infection (fever, redness, swelling), a hip dislocation, or severe pain after surgery.<\/p>\n
What Recovery Really Looks Like?<\/h3>\n
Recovery typically involves managing pain, following a physical therapy regimen, and gradually returning to normal activities. Most patients regain significant function within 6-12 weeks, with minimal restrictions.<\/p>\n
What Happens If You Delay Surgery?<\/h3>\n
Delaying surgery may result in further joint deterioration, increased pain, and more complex surgery later on.<\/p>\n
How to Prevent Recurrence or Failure?<\/h3>\n
Follow your surgeon’s recommendations, maintain a healthy weight, and avoid high-impact activities to ensure the longevity of the hip implant.<\/p>\n
Nutrition and Bone or Joint Health<\/h3>\n
Ensure adequate intake of calcium and vitamin D to support bone health and prevent future complications.<\/p>\n
Activity and Lifestyle Modifications<\/h3>\n
Engage in low-impact activities and follow your surgeon\u2019s guidelines for long-term care and mobility.<\/p>\n
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Do you have more questions?\u00a0<\/h2>\n
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[\/et_pb_sidebar][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>\n","protected":false},"excerpt":{"rendered":"
Posterior Hip Replacement Posterior hip replacement is one of the most commonly performed surgical procedures for patients suffering from severe hip arthritis. This approach, also known as Moore\u2019s or the Southern approach, provides a thorough exposure of the hip joint without cutting through key muscle groups involved in normal walking. The procedure involves replacing the […]<\/p>\n","protected":false},"author":37,"featured_media":13199,"parent":162,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_seopress_robots_primary_cat":"","_seopress_titles_title":"Posterior Hip Replacement - Complete Orthopedics Podiatry","_seopress_titles_desc":"The approach is also known as southern or Moore\u2019s approach is popular as it does not involve cutting of the abductor group of muscles.","_seopress_robots_index":"","_et_pb_use_builder":"on","_et_pb_old_content":"
Posterior hip replacement is the most common approach used for performing a total hip replacement<\/a>. The approach is also known as southern or Moore\u2019s approach is popular as it does not involve cutting of the abductor group of muscles.<\/p>
The abductors help a person to walk without limping on taking a step. The approach also offers a good exposure of the thigh bone during the surgery as compared to the anterior approach<\/a>.<\/p>
Hip replacement is the most successful surgery in the entire history of medicine. Hip replacements today last for 20 years or even a lifetime. A total hip replacement may be performed for a number of reasons but arthritis of the hip remains the most common cause.<\/p>
The arthritis<\/a> of the hip may lead to painful movements about the hip joint during walking, sitting, driving, etc. A hip replacement surgery recreates the motion of the natural joint by replacing the diseased parts with prosthetic parts<\/a>.<\/p>[caption id=\"attachment_13199\" align=\"aligncenter\" width=\"500\"]
<\/a> X-ray showing total hip replacement.[\/caption]Approaches<\/strong>
During the surgery, the surgeon gives a skin incision followed by cutting or separation of the tissue to reach the hip joint. The hip joint may be accessed through a number of different approaches. In the posterior approach, the surgeon accessed the hip joint through the back of the joint.<\/p>Similarly in the anterior approach, the surgeon accesses the joint from the front. Other less commonly used approaches are the anterolateral and lateral approaches. The hip joint is accessed from the side in the direct lateral approach and if the incision is made some distance from the side to the front, it is known as the anterolateral approach.<\/p>
The choice of surgical approach is often dependent upon a number of factors. Any prior incision, the selection of the implant, the risk of dislocation, obesity, hip deformity, and surgeon training all influence the choice of hip replacement approach.<\/p>
Posterior approach<\/strong>
The surgery is usually performed under general anesthesia or at times may be performed under spinal anesthesia. The surgeon positions the patient on their side with the affected hip facing up. The surgeon may bend the hip and the knee of the affected side with the other leg laying straight.<\/p>After cleaning and draping in the usual fashion, the surgeon gives an incision in the back of the buttock in mimicking the alphabet \u201cJ\u201d. The surgeon separates and cuts the underlying tissue known as fascia. The fascia is a tough tissue that covers the muscles.<\/p>
Next, the surgeon separates the major muscle forming the buttock known as the gluteus maximus. The surgeon separates the muscle while taking care not to disrupt the blood supply and the nerve supply of the muscle. The trochanteric bursae are cleared in the operative field.<\/p>
The affected side is manipulated in a position in order to rotate the hip inward. The inward rotating action places the small external rotator muscles in tension so the surgeon can see them clearly. The short external rotator muscles attach behind the upper part of the thigh bone. The muscles help in moving the hip outward.<\/p>
Two of the short external rotator muscles piriformis and the obturator internus muscles are tagged and cut just near the upper thigh bone. During the process, the surgeon also takes care to locate the sciatic nerve to prevent inadvertent injury.<\/p>
The hip capsule is a tough tissue that surrounds the hip joint. The tissue is cut using a special \u201cT\u201d shaped incision. The surgeon is now able to see the diseased joint and the surgeon cuts the neck of the thigh bone (femur) to separate the head of the femur from the upper thigh bone.<\/p>
The head of the thigh bone is removed from the bony socket (acetabulum) using a special instrument. The cutting of the neck with a bone saw is done keeping in mind the implant position. The surgeon then proceeds to remove osteophytes also known as bone spurs around the socket.<\/p>
The acetabulum socket is freshened with help of a reamer. The freshening of the bone in the socket helps the bone to grow on and in the acetabulum implant (cup). The reaming of the acetabulum socket is done in a position that allows maximum movement of the joint while maintaining stability. The prosthetic cup is press-fitted and may be additionally fixed to the acetabulum using screws.<\/p>
The surgeon then uses a drilling instrument to locate the canal of the upper thigh bone. Rasping instruments in the shape of the implant are then inserted and removed with a larger size each time. The rasps and broaches help to freshen the canal of the thigh bone and prepare the seat for the implant.<\/p>[caption id=\"attachment_13198\" align=\"aligncenter\" width=\"500\"]
<\/a> Intraoperative image showing posterior hip replacement.[\/caption]The last broach is left in place and the surgeon covers the neck of the trial broach with a trial head of the femur. The trail head is placed back in the socket using a maneuver and the surgeon checks for stability, range of motion, and length of the extremity.<\/p>
Upon satisfaction with the size of the trial implants, the surgeon inserts the prosthetic femoral stem in the prepared upper thigh bone. The stem is press-fitted in the canal with a special emphasis on the direction and the angle of the final position. The stem is mostly press-fitted but may be fixed with bone cement in limited cases.<\/p>
A prosthetic head made of metal alloy or ceramic is placed upon the neck. The metallic acetabulum socket is covered with a high-grade plastic liner. The head is placed back in the socket. The capsule as well as the cut short external rotators are repaired. The incision is closed in layers and a bandage is placed on the skin incision.<\/p>
The patients are placed on deep vein thrombosis precaution in the form of blood-thinning medication such as aspirin. The patients are able to stand up and walk with assistance the next day of the surgery. The majority of the patients are able to walk without assistance (calipers\/walkers) at the end of 3-4 weeks.<\/p>
As with any surgery, there may be potential complications in the form of heart attack, blood clots, infection, bleeding, failure of hardware, leg length discrepancy, etc. Although rare, the complications are discussed at length with all patients undergoing hip replacement surgery. Hip replacement surgery has been a boon to millions of patients suffering from hip pain worldwide and is one of the most common surgeries performed by orthopedic surgeons.<\/p>","_et_gb_content_width":"","footnotes":""},"class_list":["post-13200","page","type-page","status-publish","has-post-thumbnail","hentry"],"_links":{"self":[{"href":"https:\/\/2025divi.cortho.org\/index.php?rest_route=\/wp\/v2\/pages\/13200","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/2025divi.cortho.org\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/2025divi.cortho.org\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/2025divi.cortho.org\/index.php?rest_route=\/wp\/v2\/users\/37"}],"replies":[{"embeddable":true,"href":"https:\/\/2025divi.cortho.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=13200"}],"version-history":[{"count":5,"href":"https:\/\/2025divi.cortho.org\/index.php?rest_route=\/wp\/v2\/pages\/13200\/revisions"}],"predecessor-version":[{"id":58599,"href":"https:\/\/2025divi.cortho.org\/index.php?rest_route=\/wp\/v2\/pages\/13200\/revisions\/58599"}],"up":[{"embeddable":true,"href":"https:\/\/2025divi.cortho.org\/index.php?rest_route=\/wp\/v2\/pages\/162"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/2025divi.cortho.org\/index.php?rest_route=\/wp\/v2\/media\/13199"}],"wp:attachment":[{"href":"https:\/\/2025divi.cortho.org\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=13200"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
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