Minimally Invasive Total Hip Replacement
The hip joint is one of the body's largest weight-bearing joints and is the point where the thigh bone (femur) and the pelvis (acetabulum) join. It is a ball and socket joint in which the head of the femur is the ball and the pelvic acetabulum forms the socket. The joint surface is covered by a smooth articular cartilage that cushions and enables smooth movements of the joint.
Hip arthritis is one of the painful and common diseases of the hip joint caused by damage to the cartilage. Total hip replacement surgery is an option to relieve severe arthritis pain that limits your daily activities.
Minimally Invasive Total Hip Replacement vs. Traditional Total Hip Replacement
Traditionally, total hip replacement will be performed through a 10–12-inch-long incision made on the side of the hip. A minimally invasive approach has been developed in recent years where surgery is performed through one or two smaller incisions rather than the single long incision as in the traditional approach. Advantages of the newer approach are lesser muscle dissection, minimal pain, quicker recovery, and faster rehabilitation.
Minimally Invasive Total Hip Replacement Procedure
Surgery may be recommended in patients with severe cartilage damage and if conservative treatment options such as anti-inflammatory medications and physical therapy do not relieve the symptoms.
For minimally invasive hip replacement, the surgical technique and artificial implants remain the same as traditional hip replacement. However, the latter uses smaller incisions and minimal soft tissue dissection. The surgery is performed through either one or two smaller incisions. The procedure is performed under general anesthesia.
In minimally invasive total hip replacement, surgeons may use either a single-incision or two-incision approach to minimize tissue damage and improve recovery.
Single-Incision Minimally Invasive Technique:
- A 3–6 inch incision is made over the side of the hip to expose the joint.
- Muscles are gently dissected to access the joint.
- The femur is dislocated from the acetabulum (hip socket).
- The acetabulum is cleaned and arthritic bone is removed using a reamer.
- An acetabular implant is placed using screws or special cement.
- A liner made of plastic, ceramic, or metal is inserted into the socket.
- The femur is prepared by removing diseased bone and shaping it to fit the femoral component.
- The femoral stem is inserted into the thigh bone, either by press-fit or with cement.
- A metal or ceramic femoral head is placed on the stem.
- All components are secured, muscles and tendons are repaired, and the incision is closed.
Two-Incision Technique:
- A 2–3 inch incision is made over the groin to place the socket.
- A second 1–2 inch incision is made over the buttock to insert the femoral stem.
- This method takes longer and is performed with the aid of X-ray imaging.
Advantages of Minimally Invasive Total Hip Replacement
The advantages of minimally invasive total hip replacement as compared with traditional total hip replacement may include:
- Smaller incisions
- Shorter hospital stay
- Less trauma to the surrounding tissues
- Quicker recovery
- Less blood loss
- Less scarring
- Faster rehabilitation
- Minimal post-operative pain
Postoperative Precautions for Minimally Invasive Total Hip Replacement
After undergoing minimally invasive total hip replacement, you must take special care to prevent dislocation of the new joint and to ensure proper healing.
- Avoid combined movement of bending your hip and turning your foot inwards.
- Keep a pillow between your legs while sleeping for 6 weeks.
- Never cross your legs and bend your hips past a right angle (90°).
- Avoid sitting on low chairs.
- Avoid bending down to pick up things, instead use a grabber device.
- Use an elevated toilet seat.