Minimally Invasive Hip Surgery
Anterior approach: A New hip surgery Allows Faster Recovery
With the anterior approach for hip replacement surgery, surgeons make one small incision on the front of the hip, allowing the surgeon to work between the muscles rather than detaching them from the bone. This results in less pain and quicker recovery. To allow the surgeon to perform the surgery while keeping the muscles attached, a HANA™ orthopaedic table is used to improve access to the hip. This approach also allows the surgeon to confirm accurate alignment and positioning of the implant before leaving the operating room. These factors contribute to a long-lasting hip prosthesis.
Mini-Incisions for Hip Replacement Cuts Pain and Recovery Time
Patients who undergo minimally invasive hip replacement surgery experience less discomfort and are back on their feet in about two weeks. The procedure requires just two small incisions and causes far less trauma to the body than traditional hip replacement surgery. So patients have a much more positive experience following surgery.
Minimally Invasive Hip Replacement Is a Major Advancement
With traditional hip replacement surgery, surgeons begin by making a large eight to ten inch incision. Then they cut the muscles and tendons around the hipbone to reach and replace the damaged joint. The patient spends three to five days in the hospital and recovery typically takes about three months.
With a minimally invasive hip replacement, the surgeon operates through incisions that are just one to two inches long, dramatically reducing the time the patient spends in the hospital and in recovery. Using X-ray guidance and special surgical instruments, the surgeon implants the same metal and plastic prostheses used in traditional surgery. Because it involves less cutting of muscle, tendons and ligaments, patients recover more swiftly and may go home the day after surgery. That's compared to a four or five day hospitalization for traditional hip replacement surgery.
Minimally invasive hip replacement surgery can be performed through one small incision or two very small incisions. The method chosen by the surgeon will depend on multiple factors, including the patient's arthritis condition, bone type, body size and body shape.
In the two-incision method, the surgeon makes two small incisions around the hip, each measuring just one to two inches long. A standard implant is then inserted through these incisions. By using two small incisions, there is less disruption to skin, muscles and ligaments. This in turn results in less pain and faster recovery than a standard hip replacement.
In the one-incision method, the surgeon makes an incision less than four inches long. This small incision disrupts less skin, muscles and ligaments, therefore causing less pain and allowing for a faster recovery. The components inserted may or may not be cemented.
Benefits to Patients
There are a number of benefits for patients who undergo the new minimally invasive hip replacement procedures. In traditional surgery, muscles and tendons are cut which can result in a long and painful recovery. A minimally invasive surgery patient may experience the following benefits:
- Less pain after surgery
- Less trauma, since muscles and tendons are not cut.
- Less time in the hospital. A typical stay is two days, as compared with the three to five for traditional hip replacement.
- Faster recovery—a matter of weeks rather than months.
- Less conspicuous scars.
- Fewer complications, such as hip dislocation and excessive wear.
- Reduced blood loss.
Replacing the Hip
In all hip replacement surgeries, the surgeon removes the damaged femoral head and resurfaces the joint with metal and plastic implants. The new implants result in smooth movement between the ball and socket, decreasing pain and stiffness and restoring hip function. The same high quality, clinically proven prostheses are used in minimally invasive surgery as those used in traditional surgery.
The replacement hip, called a prosthetic implant, is comprised of a stem, ball and socket. The socket implant is attached by using a special kind of epoxy cement for bones or by pressing the implant into the socket so that it fits very tightly and is held in place by friction. Some implants may have special surfaces with pores that allow bone to grow into them to help hold the implant in place. Depending on the condition of the patient's bone, the surgeon may also decide to use screws to help hold the implant in place. When the shell portion of the socket implant is in place, the plastic liner is locked into place inside the shell.
The ball portion of the implant is attached to a long metal stem that fits down into the femur (upper leg bone). The bone has relatively soft, porous bone tissue in the center. Special instruments are used to clear this tissue and mold the area to fit the shape of the implant stem. The stem implant will be inserted into this area and held in place by either using the special cement for bones, or by making it fit very tightly in the canal. The stem implant may have a special surface with pores that allow bone to grow into them. When all the implants are in place, the surgeon places the new ball that is now part of the upper leg bone into the new socket that is secure within the pelvic bone.