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During any hip replacement surgery, the damaged bone is cut and removed, along with some soft tissues. In minimally invasive surgery, a smaller surgical incision is used and fewer muscles around the hip are cut or detached. Despite this difference, however, both traditional hip replacement surgery and minimally invasive surgery are technically demanding and have better outcomes if the surgeon and operating team have considerable experience.
To perform a traditional hip replacement:
(Left) The individual components of a total hip replacement. (Center) The components merged into an implant. (Right) The implant as it fits into the hip.
In minimally invasive total hip replacement, the surgical procedure is similar, but there is less cutting of the tissue surrounding the hip. The artificial implants used are the same as those used for traditional hip replacement. However, specially designed surgical instruments are needed to prepare the socket and femur and to place the implants properly.
Minimally invasive total hip replacement can be performed with either one or two small incisions. Smaller incisions allow for less tissue disturbance.
The hospital stay after minimally invasive surgery is similar in length to the stay after traditional hip replacement surgery–ranging from 1 to 4 days. Physical rehabilitation is a critical component of recovery. Your surgeon or a physical therapist will provide you with specific exercises to help increase your range of motion and restore your strength.
Minimally invasive total hip replacement is not suitable for all patients. Your doctor will conduct a comprehensive evaluation and consider several factors before determining if the procedure is an option for you.
In general, candidates for minimal incision procedures are thinner, younger, healthier, and more motivated to participate in the rehabilitation process, compared with patients who undergo the traditional surgery.
Minimally invasive techniques are less suitable for patients who are overweight or who have already undergone other hip surgeries. In addition, patients who have a significant deformity of the hip joint, those who are very muscular, and those with health problems that may slow wound healing may be at a higher risk for problems from minimally invasive total hip replacement.
Minimally invasive and small incision total hip replacement surgery is an evolving area and more research is needed on the long-term function and durability of the implants.
The benefits of minimally invasive hip replacement have been reported to include less damage to soft tissues, leading to a quicker, less painful recovery and more rapid return to normal activities. Current evidence suggests that the long-term benefits of minimally invasive surgery do not differ from those of hip replacement performed with the traditional approach.
Like all surgery, minimally invasive surgery has a risk of complications. These complications include nerve and artery injuries, wound healing problems, infection, fracture of the femur, and errors in positioning the prosthetic hip implants.
Like traditional hip replacement surgery, minimally invasive surgery should be performed by a well-trained, highly experienced orthopaedic surgeon. Your orthopaedic surgeon can talk to you about his or her experience with minimally invasive hip replacement surgery, and the possible risks and benefits of the techniques for your individual treatment.