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.
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 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.
Arthritis is inflammation of the joints resulting in pain, swelling, stiffness and limited movement. Hip arthritis is a common cause of chronic hip pain and disability. The most common type of arthritis affecting the hip is osteoarthritis which is characterized by progressive wearing away of the joint cartilage. As the protective cartilage wears down, the bone ends rub against each other and cause pain in the hip. It is more common in individuals aged above 50 years and tends to run in families.
The most common symptom of hip arthritis is dull, aching joint pain and stiffness resulting in limited mobility. There may be pain in the groin, thigh and buttock area and sometimes pain may be referred to the knee. Vigorous activity and walking for long distances can increase the pain and stiffness which may cause limping while walking.
Diagnosis is made by evaluating your symptoms, medical history, physical examination and X-rays. Sometimes, additional imaging tests such as MRI and CT scans may be needed to confirm the diagnosis.
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 difference is smaller incisions and minimal soft tissue dissection. The surgery is performed through a smaller incisions. The procedure is performed under general or regional anesthesia.
In a minimally invasive approach, your surgeon makes a 3–4-inch incision over the hip to expose the hip joint. The muscles are minimally dissected to reach the joint. The femur is dislocated from the acetabulum. The surface of the socket is cleaned and the arthritic bone is removed using a reamer. The acetabular implant is inserted into the socket, occasionally using screws. A liner material of plastic, ceramic or metal is placed inside the acetabular component. The femur or thigh bone is then prepared by removing the arthritic bone using special instruments and shaped to exactly fit the new metal femoral component. The femoral stem is then inserted into the femur either by a press fit or using bone cement. Then the femoral head component made of metal or ceramic is placed on the femoral stem. All the new parts are secured in place using special cement. The muscles and tendons around the new joint are repaired and the incision is closed.
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
After undergoing total hip replacement, you must take special care to prevent the new joint from dislocating and to ensure proper healing. These precautions vary depending on the type of hip surgery you had.
Please contact your surgeon prior to undergoing any dental procedures or other invasive surgical procedures. Appropriate antibiotics are often indicated in these situations and should be discussed with our team as well as your dental or surgical provider.
Risks and Complications
As with any major surgical procedure, there are certain potential risks and complications involved with total hip replacement surgery. They include:
- Limb length inequality
- Injury to nerves and blood vessels
- Formation of blood clots in the leg veins
- Implant malposition
- Fracture of the femur or pelvis
- Failure of the implant
In the event of an emergency dial 911.
In the event of a concerning post-operative complication, please contact us immediately for prompt support. Most concerns can be appropriately addressed by our team and we will make every effort to be available to you in a timely fashion. Avoid going to the Emergency Department for surgical issues unless necessary, or unless instructed by our team.