Hip replacement is one of the most successful operations in orthopedic surgery for relieving pain from advanced hip arthritis. Dr. Dold performs total hip replacement using the direct anterior approach (DAA). He reaches the hip joint through the natural interval between muscles at the front of the hip, rather than cutting through them.
- Muscle-sparing approach through the front of the hip
- Performed on a specialized anterior-approach surgical table, with live X-ray (fluoroscopy) during surgery
- OrthoGrid Hip AI® software measures implant position, offset and leg length in real time during the operation
- Many patients go home the same day
- Most patients have no formal hip precautions after surgery
What is the direct anterior approach?
In a total hip replacement, the worn ball (femoral head) and socket (acetabulum) are replaced with implants. The approach is the path the surgeon takes to reach the joint. The direct anterior approach works between the tensor fasciae latae and sartorius muscles at the front of the hip. That lets the surgeon reach the joint without detaching the muscles and tendons that surround it.
Other approaches, such as the posterior approach, are also well established and give excellent results. The right approach depends on your anatomy, your health and your surgeon’s experience. Dr. Dold will talk through whether the anterior approach is right for you.
Who is a candidate?
Anterior hip replacement may be an option if you have:
- Hip arthritis (osteoarthritis, post-traumatic arthritis or inflammatory arthritis) that limits walking, sleep or daily activity
- Avascular necrosis (osteonecrosis) of the femoral head
- Hip pain that has not improved with non-surgical treatment such as activity changes, physical therapy, medication or injections
For younger, active patients with hip pain but a well-preserved joint, hip arthroscopy may be an alternative. Dr. Dold performs both procedures and can help you weigh them. Learn about hip arthroscopy.
What happens during surgery
- You are positioned on your back on a specialized anterior-approach table.
- A single incision, typically about 3 to 4 inches long, is made at the front of the hip.
- The muscles are gently moved aside, and the arthritic femoral head is removed.
- The socket is prepared and a new cup and liner are placed.
- A stem is placed in the thigh bone with a new ball on top. Dr. Dold usually uses cementless (press-fit) implants that the bone grows onto. A cemented stem may be used when needed, for example in patients with weaker bone.
- Live X-ray is used during surgery to check cup position and leg length before the incision is closed.
AI-assisted implant positioning
During surgery, Dr. Dold uses OrthoGrid Hip AI®, an AI-powered platform built for direct anterior (DA) hip replacement. Images from the intraoperative fluoroscope (live X-ray) are sent to the system automatically. The software corrects for image distortion and tracks the patient’s functional pelvic plane. It then displays smart grid overlays and real-time measurements of:
- Cup positioning: the angle and placement of the new hip socket
- Leg length: identifying and correcting leg length discrepancy (LLD)
- Offset: the distance that affects hip muscle tension, stability and a natural gait
Because these measurements are available while Dr. Dold is still operating, he can fine-tune implant position before the incision is closed.
The goals are precise implant placement, well-matched leg lengths, a stable hip and a smooth recovery. Accurate positioning is linked in research to better hip stability and implant wear. Final results still depend on each patient’s anatomy, bone quality and recovery.
Anesthesia and where surgery is done
Most patients have spinal anesthesia with sedation. The final plan is made with your anesthesiologist. Dr. Dold performs anterior hip replacement at Baylor Surgicare at The Star, Medical City Frisco and other facilities in the area. The location can depend on your health needs and on your insurance plan and coverage, and our team will help you with this.
Recovery timeline
Everyone recovers differently. This is a general guide, and Dr. Dold’s team will give you a personal plan.
| When | What to expect |
|---|---|
| Day of surgery | Walking with a walker or cane with the physical therapy team. Many patients go home the same day. |
| First 2 weeks | Walking at home with support, home exercises, wound care and pain control. First follow-up visit with Dr. Dold’s team at about 10 to 14 days. |
| 2 to 6 weeks | Weaning off the walker or cane as strength and balance return. Physical therapy progresses. |
| 6 to 12 weeks | Most daily activities. Dr. Dold clears each patient individually for driving and work. Timing depends on which hip was replaced, your pain medicine, and the kind of work you do. |
| 3 months and beyond | Continued strength gains. Discuss low-impact sports such as golf, cycling and swimming with Dr. Dold. |
Most of Dr. Dold’s anterior hip patients do not need formal hip precautions (for example, restrictions on bending past 90 degrees or crossing the legs). He will tell you if your case is different.
Risks
All surgery has risks. For hip replacement these include infection, blood clots, dislocation, a difference in leg length, fracture around the implant, wear or loosening over time, and anesthesia-related risks. Some risks are more specific to the anterior approach. Temporary or permanent numbness on the outer thigh can occur from irritation of the lateral femoral cutaneous nerve. Wound-healing problems can also occur in some patients. Dr. Dold will review your individual risks at your consultation.
Why see Dr. Dold for hip replacement
- Board certified by the American Board of Orthopaedic Surgery, with subspecialty certification in Sports Medicine
- Fellow of the American Orthopaedic Association (FAOA), the American Academy of Orthopaedic Surgeons (FAAOS), the American College of Surgeons (FACS) and the Royal College of Surgeons of Canada (FRCSC)
- Orthopedic surgery residency at the University of Toronto; sports medicine and arthroscopy fellowship at NYU Langone / Hospital for Joint Diseases
- Performs both hip arthroscopy (hip preservation) and hip replacement, so your options are weighed together
- D Magazine Best Doctors (Collin County), 2019–2026
- Rated 4.9 on Google
Frequently asked questions
Is anterior hip replacement better than posterior hip replacement?
Both approaches are well established, and long-term results are similar. Some studies suggest the anterior approach may allow a slightly faster early recovery, but the difference tends to narrow over the following months. The best approach depends on your anatomy and your surgeon’s experience.
Will I go home the same day?
Many of Dr. Dold’s patients go home the same day. Whether that is right for you depends on your health, your home support and how you do with physical therapy after surgery.
Will I have hip precautions after surgery?
Most anterior hip patients have no formal hip precautions. Dr. Dold will let you know if your situation calls for any.
How does AI help during hip replacement?
Dr. Dold uses OrthoGrid Hip AI®, AI-powered software that analyzes intraoperative fluoroscopic (live X-ray) images in real time. It measures cup positioning, hip offset and leg length discrepancy (LLD). That gives Dr. Dold precise measurements to guide adjustments before the operation is finished. The aim is accurate implant placement and equal leg lengths. It supports the surgeon’s judgment and doesn’t replace it.
How long does a hip replacement last?
Modern hip replacements are designed to last many years, and most last well over a decade. Longevity depends on factors such as activity level, body weight and bone quality.
When can I drive after anterior hip replacement?
That depends on which hip was replaced, whether you still need prescription pain medicine, and how quickly your strength and reaction time return. Dr. Dold will clear you at a follow-up visit.
Does insurance cover hip replacement?
Hip replacement is generally covered when it is medically necessary. Star Orthopedics accepts most insurance plans, including Medicare and Tricare. Our team can help check your coverage.
Medically reviewed by Andrew P. Dold, MD, FAOA, FAAOS, FACS, FRCSC. Last reviewed September 30, 2026. This page is general information, not medical advice.
“The results of my total hip replacement surgery performed by Doctor Dold and Karina were excellent… The day after the surgery I had the expected muscle pain but no joint pain… I also walked one mile without a cane or walker… Five weeks after the surgery I participated in a 10K and did it without any pain and at a fast pace. Now at five months I have been doing all my activities such as workouts at the gym, gardening and other physical activities without any limitations.”
— Harry B., Total hip replacement (Google review). Individual results vary.
