Minimal
Invasive Hip Surgery
This
type of hip replacement surgery became popular in 2001. What
is it? It is not repairing or removing only a little (minimal)
part of the hip joint. It is the replacement of the entire hip
joint through a much smaller opening in the skin and soft tissue
around the hip joint. It is the ‘road’ to the hip
joint that is made smaller.
How
is it done? Instead of cutting the skin open to 8 or10 inches
as in standard
hip surgery, a shorter cut of 2 to 3 inches is used.
So, it is called ‘minimal invasive’. Some surgeons
use the posterior approach and the incision can be as short as
1-1/2 inch in length. Other surgeons use two short incisions: one
in the front to put in the socket and another cut on the side to
insert the ball and stem (femoral) component
In
order to get the hip joint deep below through a posterior approach
with a small skin and tissue cut, specially designed instruments
are used
to pull
and
spread
the skin and muscles apart during surgery. Since the hip joint
is 3 to 4 inches below the skin, the surgeon cannot see into the
hip joint with his eyes as well as in a standard 8 to 10 inch incision.
So, after the bones are cut, the implants have to be installed
using special guides to make sure that they are properly placed.
Correct placement of the artificial hip components is then confirmed
by x-rays after surgery in the recovery room.
When
a small cut in the skin is used, it is cosmetically very pleasant
because the scar can be very short. Also, the muscles
under the skin are cut less or split less than the standard posterior
or lateral incisions. This certainly helps in the healing of the
soft tissues and there is less pain. As a result, the patient can
leave the hospital sooner. For younger patients who cannot take
off months of rehabilitation, this is an attractive alternative
to the standard hip replacement procedure. However, small skin
and muscle openings give the surgeon less of a view of what he
sees during surgery. This limitation may lead to the incorrect
placement of the artificial hip components and result in dislocation.
Then, it would put a highly successful standard total hip replacement
procedure (using long incisions) into a risky one.
|