Total hip replacement


Hip Replacement

ANTERIOR APPROACH by dr. De Loore & dr. Van Quickenborne
POSTERIOR APPROACH by dr. De Smet & dr. Van Quickenborne

Titanium ingrowth prosthesis,

The vast majority of placed prostheses in the world are Total Hip Prostheses. (99%)

We place a titanium ingrowth prosthesis, so it has to grow into the bone.

The frictional torque between the two components is Ceramic on Ceramic (=CoC)

– No allergy to titanium or ceramics
– Very wear resistant

We see a survival of this prosthesis of  92% over at least 15 years (92% survival > 15 years). This means that with this type of prosthesis (THP) 92% is still in place after 15 years or longer. We expect that most patients will be able to have their prosthesis in place for life.


The Total Hip Prosthesis is placed according to the anterior approach. Dr. De Loore is an international reference surgeon for this technique. This technique requires experience and expertise: with more than 3000 anterior hip surgeries, this expertise is readily available in the Anca team.

With this technique, no muscle or tendon is cut or loosened. This promotes short-term rehabilitation and maintenance of strength. After full recovery, there are no restrictions and all activities can be resumed. However, we know from experience that high-impact contact sports are more difficult for such prosthesis. It is allowed however, the prosthesis will not break.

The biggest complication with any orthopaedic procedure, and therefore also the placement of a THP, is an infection. The Anca team works in a standardised way with its own permanent team of nurses, and therefore also scores with one of the lowest chances of infection in Belgium.

The prosthesis is fully reimbursed by the health insurance company and has excellent long-term results.

Frequently asked questions
Hip resurfacing



Hip resurfacing comes closest to the natural hip.

Why choose resurfacing?
– patients live longer
– higher level of activity possible (also impact sports)
– prosthesis won’t be influenced by activity level
– biomechanics of the hip are more restored
– less bone removal
– easier revision (with expertise)

Is there a downside?
Yes, resurfacing needs to be done by an experienced surgeon. Luckily, the Anca clinic team has performed more than 10000 surgeries!

metaL oN metal RESURFACING

This prosthesis is wear-resistant and tolerates impact sports very well. We see from our results that approximately 80% of resurfacing patients can perform impact sports. The most difficult thing for any prosthesis is running.

A metal on metal prosthesis is wear-resistant but, because of the friction, releases a minimal amount of metal ions into the joint and into the body. You can have an allergic reaction to this. Women have a 1/300 chance of having such an allergic reaction. Men have a much smaller chance of allergies: 1/1500. We know that the friction and wear with larger dentures is less than with the smaller sizes. (Women usually have smaller sizes). Hence, the ideal candidate is a man with a large hip (less chance of increased friction and less chance of allergy).

A major advantage with resurfacing is the extra step with revision. There is much more bone present and the results of the revision are much better than if a Total Hip has already been placed.

What is the difference between MOM and COC resurfacing?
– Metal on metal has a 23 year follow up with excellent results, for male patients younger than 50, this even goes up to 95-97% survival, in comparison to 60-70% with a total hip replacement!
– Ceramic on ceramic is the same procedure, as technically difficult, but with experience and good placement it can be done perfectly. It might even be better than metal on metal, but we only have a 2 year follow up. The results are excellent, but metal on metal has a much longer follow up.
– Ceramic on ceramic has less risk of metal problems and has already been used for >40 years in total hip replacements.
– With metal on metal some people can not fully run, or have problems with running. This can be due to the heating of the fluid in the joint; we hope this does not happen with COC.
– No metal ion analysis is needed with COC.
– Most patients with COC tell us that the alarm at customs at the airport does not go off.

the posterior approach

This prosthesis is placed with the posterior approach. To do this, a muscle and some tendons have to be cut.

For the Belgian patients:
Reimbursement by your health insurance depends on your age, femoral head diameter and surgeon.

Frequently asked questions

Revision surgery



Anca Clinic helps the most difficult cases with revision surgery, especially those that could not be helped anywhere else.

The Anca team’s surgeons have extensive experience in hip revision surgery, ranging from simple replacement of the hip pan or stem to complex revisions involving reconstructions of the acetabulum (pelvis) or femur (thigh bone).

Patients with deep infections around the hip prosthesis also find their way to the Anca Clinic. Given the complexity and diversity of revision surgery, we would like to see patients for a consultation or you can send us an introductory email with your specific problem.


Frequently asked questions