MIS Hip Replacement
Total hip replacement surgical techniques have been refined over the last decade. Hip replacement can be done with a shorter hospitalization, less discomfort and fewer complications due to recent improvements in the surgical approach. One of the most important refinements of technique allows the operation to be done through a smaller incision.
The surgical approach and the size of the incision is a critically important element of hip replacement surgery. The success of this operation is largely related to the surgeon’s ability to gain adequate exposure to the arthritic hip joint. Recent enhancements in surgical technique and instrumentation have allowed more limited surgical approaches in certain patients. The use of these instruments, selected implants, and minor modifications of the surgical dissection allow hip replacement to be done through a 4-6 inch incision. The potential benefits of this less invasive technique are significant:
- Better cosmetics
- Less postoperative pain
- Less blood loss
- Earlier rehabilitation
- Fewer wound complications
It is important, however, to understand that small incisions for hip replacement are a recent development. Precise placement of hip components remains the primary goal of the surgery, and this goal should not be compromised for a smaller incision. Patient factors such as weight, stiff hips, previous hip surgery, and hip deformity can require the standard sized longer incision. Patients who are interested in this approach need to appreciate that there are very important and specific requirements:
- Careful patient selection
- Specialized retractors
- Surgical team accustomed to the approach
- Specialized components
The American College of Rheumatologists has called total joint replacement "The single greatest advancement of arthritis treatment in this century." Improved surgical techniques, development of new materials, and the evolution of detailed preoperative and postoperative protocols have all led to enhanced results in hip replacement. The "mimimally invasive approach" allows hip replacement to be done through a smaller incision.