Even though a hip replacement, or arthroplasty, is now a common orthopedic procedure, it can still seem like an ordeal to some patients. That’s because the traditional approach to hip replacement is a complex procedure involving a 10- to 12-inch long incision as a means of replacing the hip joint with an implant or “prosthesis.”
But the good news is that there is a minimally invasive alternative to the traditional approach that only involves one or two shorter incisions, which results in less pain and a speedier recovery.
Here’s how the two approaches differ.
Traditional Hip Replacement
During traditional hip replacement, the orthopedic surgeon makes the longer incision on the side of the hip. Muscles are split and detached from the hip to allow the surgical team to have a full view and to dislocate the hip. Next, the damaged femoral head is replaced with a metal stem that is placed into the hollow center of the femur bone, and a metal or ceramic ball that is fitted on the upper part of the stem. Using a screw or cement, a metal socket is secured to replace the damaged cartilage surface of the acetabulum (socket). And finally, a plastic, ceramic, or metal spacer is inserted between the ball and socket to produce a smooth, gliding surface.
Minimally Invasive Hip Replacement
The minimally invasive hip replacement surgery is similar, but it involves less slicing of the tissue that is adjacent to the hip. The same artificial implants are applied, but the procedure requires surgical instruments that are specially designed to prime the socket and femur, as well as properly position the replacement prosthesis. Also, it can be performed with either one or two small incisions, which allows for less tissue intrusion.
Depending on the patient’s size and the amount of difficulty involved, a single incision measuring just 3 to 6 inches can be made, usually on the outside of the hip. Although muscles and tendons are still split and detached, it is performed to a lesser extent than with the traditional approach. The muscles and tendons can be repaired once the implants are installed, encouraging healing and helping to prevent dislocation of the hip.
If the minimally invasive surgical procedure requires two incisions, one measuring 2 to 3 inches long is done over the groin to allow for placement of the socket. The other incision, measuring just 1 to 2 inches long, is done over the buttock to enable placement of the femoral stem. With a two-incision procedure, the surgeon often uses X-rays for guidance, and the operation itself may take longer than traditional surgery.
As with any type of hip replacement surgery – traditional or minimally invasive – the patient may need to remain in the hospital for up to four days. This is followed by a period of physical rehabilitation to ensure a successful recovery, and restoration of strength and range of motion.
Are You a Candidate for Minimally Invasive Hip Replacement?
Before you undergo minimally invasive hip replacement, your doctor will perform a comprehensive evaluation, considering several factors before recommending the procedure. The best candidates for this approach tend to be younger, thinner, overall healthier, and more motivated to commit to the rehabilitation process than those who undergo traditional surgery.
Those for whom minimally invasive techniques are less suitable include patients who are overweight or very muscular, have significant deformity of the hip joint, have undergone other hip surgeries, or have health problems that may slow down wound healing – as these bring a higher risk for complications from the surgery.
Expert Hip Treatment in Colorado Springs
At Colorado Center of Orthopaedic Excellence, our orthopedic and sports medicine experts offer nonsurgical hip treatment. When surgery is warranted, our orthopedic surgeons utilize the least invasive techniques available, including minimally invasive hip replacement and direct anterior hip replacement.