SPAIRE vs Anterior Hip Replacement
Two muscle-sparing approaches to total hip replacement, compared honestly. Written from a SPAIRE-trained surgeon's perspective: where each approach shines, and how to decide.
The short answer
SPAIRE and anterior hip replacement are both modern, muscle-sparing approaches to total hip replacement. SPAIRE goes in from the back of the hip and keeps the piriformis and obturator internus tendons intact. Anterior goes in from the front, working between muscle planes. Both aim to support faster, more confident early mobilisation. Professor Paul Lee uses SPAIRE wherever a patient is clinically suited because it preserves the natural posterior stability of the hip and suits a wider range of anatomies and body types.
SPAIRE vs anterior hip replacement, point by point
Suitability for either approach is confirmed at consultation. Professor Lee will give an honest opinion if a different approach is more appropriate for you.
Why Professor Lee uses SPAIRE
Professor Lee trained in the SPAIRE technique at the Exeter Hip Unit under Professor Timperley, who developed and published the approach. He uses SPAIRE as his standard approach for total hip replacement because:
- It keeps the natural stability of the hip intact. By not detaching the piriformis and obturator internus, SPAIRE does not rely on tendon reattachment healing for posterior stability.
- It is anatomy-flexible. SPAIRE works across a wider range of body types and pelvic anatomies than the anterior approach, which can be more technically demanding in larger patients.
- It does not require a specialised traction table. Equipment variation between hospitals is reduced, and intra-operative positioning is controlled directly by the surgeon.
- It is designed to support faster, confident early mobilisation for patients who are clinically suited.
Anterior hip replacement is a perfectly reasonable approach in the right hands and for the right patient. It is not the right approach for every patient, and neither is SPAIRE. That decision is made at consultation, with imaging review and an honest conversation about your goals.
SPAIRE vs anterior hip replacement: common questions
What is the main difference between SPAIRE and anterior hip replacement?
SPAIRE and anterior hip replacement are both muscle-sparing approaches, but they reach the hip from opposite sides. SPAIRE is a posterior approach that keeps the piriformis and obturator internus tendons intact. Anterior hip replacement comes in through the front of the hip and works between muscle planes. Both aim to limit muscle damage, but they suit different anatomies.
Is SPAIRE better than anterior hip replacement?
Neither approach is universally better. For patients who are clinically suited to it, SPAIRE has two advantages: it suits a wider range of body types and anatomies than the anterior approach, and it preserves the natural posterior stability of the hip without relying on tendon reattachment. The right approach for any individual is a clinical decision made at consultation with Professor Paul Lee.
Why does Professor Paul Lee use SPAIRE for hip replacement?
Professor Lee trained in SPAIRE at the Exeter Hip Unit under Professor Timperley, who developed and published the technique. He uses SPAIRE as his standard approach for total hip replacement wherever a patient is clinically suited, because it preserves the small rotator tendons that contribute to posterior hip stability and is designed to support earlier confident mobilisation.
Is recovery faster with anterior or SPAIRE hip replacement?
Both approaches are designed to support faster recovery than traditional posterior hip replacement. Individual recovery depends on more than the approach: it depends on the patient’s overall health, pre-operative fitness, the quality of post-op physiotherapy and the surgeon’s experience with the technique. The £17,800 SPAIRE package at Lincolnshire Hip Clinic includes unlimited post-op physiotherapy in Grantham or Sleaford to support recovery.
Does anterior hip replacement leave a smaller scar than SPAIRE?
Scar size is usually similar between modern muscle-sparing approaches and depends more on the patient and the surgeon than on the named technique. The clinical priority is muscle and tendon preservation, not scar length.
Which approach has fewer dislocations?
Modern posterior approaches that preserve the small rotator tendons, including SPAIRE, are designed to reduce the dislocation risk historically associated with older posterior techniques. Anterior approaches also have low dislocation rates. Dislocation risk depends on technique execution, component positioning and patient factors, all of which are assessed and planned for at consultation.
Can I have a SPAIRE hip replacement if I have already been offered an anterior approach?
Yes. You can ask for a second opinion. Professor Lee will review your history, imaging and symptoms and give an honest opinion on whether a SPAIRE hip replacement is the right approach for you, or whether the original recommendation should stand. You can book a free discovery call or a £250 private consultation directly, no GP referral required.
Next steps
SPAIRE technique
Read the full SPAIRE hip replacement page
How SPAIRE preserves the small rotators, what the acronym means and how Professor Lee performs the technique.
Free discovery call
Talk it through, no commitment
A free non-medical call to walk through both approaches in your context. No GP referral required.
Private consultation
See Professor Lee for a second opinion
A 30-minute £250 private consultation with Professor Lee. Bring any imaging and a written plan to leave with.
Cost & what’s included
See the £17,800 SPAIRE package
Surgery and overnight stay at the 5-star Weymouth Street Hospital, included luxury car service and unlimited local physio.
Explore more
The £17,800 private hip replacement package, the SPAIRE technique, recovery support and everything else you need to make the right decision.