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.