MIS Hip Replacement

Total hip replacement surgical techniques have been refined over the last decade. Hip replacement can now be done as an outpatient in the surgery center or with a short hospitalization. Improved techniques have resulted in less discomfort and fewer complications. Changes in Surgical approach such as a minimally invasive Anterior Approach (from the front) and Posterior Approach (from the back) have enhanced recovery. Refinements of technique have allowed us to operate through a smaller incision, resulting in less soft tissue inflammation and less pain.

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
• Outpatient / same day discharge, Hip Replacement

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 and equipment
• 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 “minimally invasive approach” allows hip replacement to be done through a smaller incision. It also allows for rapid recovery.