Total Hip Arthroplasty

George Washington University Hospital is committed to delivering the highest quality and most advanced care to its patients receiving a hip replacement. Multiple options exist at GW Hospital for minimally invasive approaches to surgery. The approach your surgeon takes will depend on their preference. We have surgeons specializing in both Direct Superior and Anterior total hip arthroplasty.

Patients undergoing minimally invasive hip replacement surgery may experience less discomfort and have a faster recovery following the procedure as compared to more traditional approaches. During the procedure, a surgeon operates through incisions that are just two to three inches long (the method depends on the patient's arthritis condition, bone type, and body size/shape) with the assistance of X-ray guidance and special surgical instruments. Because it involves less cutting of muscle, tendons and ligaments, patients experience less trauma to the body, and may recover more quickly. Having surgery this way may allow patients to go home the day of the surgery, or only one day after.

Direct Superior Approach

With a Direct Superior Approach to the hip, your surgeon makes a single incision just over the side of your hip. Only a single tendon is cut to facilitate access to the hip, which is then repaired at the conclusion of the procedure. Studies suggest this approach results in an equal or greater degree of muscle and tendon preservation as compared to other minimally invasive approaches with a low risk of complications and improved early recovery.1

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 both minimally invasive and traditional surgery.

The replacement hip 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.

1Amanatullah, D.F., Masini, M.A., Roger, D.J. and Pagnano, M.W., 2016. Greater inadvertent muscle damage in direct anterior approach when compared with the direct superior approach for total hip arthroplasty. Bone Joint J, 98(8), pp.1036-1042.
Individual results may vary. There are risks associated with any surgical procedure. Talk with your doctor about these risks to find out if minimally invasive surgery is right for you.