Minimally Invasive Total Hip Replacement

A primary difference between minimally invasive hip replacement surgery and traditional hip replacement surgery is the amount of skin, muscle, and other soft tissues that must be cut. The hope is that minimally invasive techniques will allow for an easier recovery in the short term and provide equal or better results in the long term.

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The Goals of Minimally Invasive Hip Replacement Surgery

A surgeon may recommend minimally invasive hip replacement because it tends to:

• Do less damage to the skin by making a smaller incision, typically 3 to 5 inches long, compared to 6 to 10 inches long for a traditional surgery
• Leave a smaller scar(s)
• Do less damage to the joint’s surrounding muscles and other soft tissue

  See Total Hip Replacement Surgery Risks and Complications

• Possibly enable a patient to recover and rehabilitate faster¹Gollwitzer H. [The minimally invasive AMIS technique for total hip replacement : Video article]. Orthopade. 2018 Sep;47(9):782-787. doi: 10.1007/s00132-018-3591-y. Review. PubMed PMID: 29974162.^,2Kutzner KP, Donner S, Schneider M, Pfeil J, Rehbein P. One-stage bilateral implantation of a calcar-guided short-stem in total hip arthroplasty : Minimally invasive modified anterolateral approach in supine position. Simultan-bilaterale Implantation einer kalkargeführten Kurzschaftprothese : Minimal-invasiver anterolateraler Zugang in Rückenlage. Oper Orthop Traumatol. 2017;29(2):180–192. doi:10.1007/s00064-016-0481-5

  See Total Hip Replacement Surgery Recovery

Research generally suggests there are few long-term differences for patients,³Capuano N, Grillo G, Carbone F, Del Buono A. Total hip arthroplasty performed with a tissue-preserving technique using superior capsulotomy. Int Orthop. 2018 Feb;42(2):281-287. doi: 10.1007/s00264-017-3722-9. Epub 2017 Dec 28. PubMed PMID: 29285665. As cited in Migliorini F, Biagini M, Rath B, Meisen N, Tingart M, Eschweiler J. Total hip arthroplasty: minimally invasive surgery or not? Meta-analysis of clinical trials. Int Orthop. 2019 Jul;43(7):1573-1582. doi: 10.1007/s00264-018-4124-3. Epub 2018 Aug 31. Review. PubMed PMID: 30171273.^,4Migliorini F, Biagini M, Rath B, Meisen N, Tingart M, Eschweiler J. Total hip arthroplasty: minimally invasive surgery or not? Meta-analysis of clinical trials. Int Orthop. 2019 Jul;43(7):1573-1582. doi: 10.1007/s00264-018-4124-3. Epub 2018 Aug 31. Review. PubMed PMID: 30171273. though more study is needed.

It Is Still Major Surgery

Minimally invasive hip replacement surgery is:

• Major surgery, just like a traditional hip replacement. It requires cutting and altering of bones and attaching prosthetic joint components.
• Done with a smaller incision and less of the joint area exposed, so the surgeon has a limited view of the area they are operating on.
• Considered a technically demanding procedure. It is most successful when performed by a well-trained, experienced orthopedic surgeon.

Because it is a technically challenging surgery, the patient’s choice of surgeon is important.

An Experienced Surgeon Matters

There is no credentialing system that certifies orthopedic surgeons to perform minimally invasive techniques for hip replacement. Moreover, there is a steep learning curve for surgeons who are new to this surgery. Therefore, a patient should ask a surgeon:

• How often does the surgeon perform this specific surgery?
• What are the surgeon’s success and complication rates regarding the specific procedure?
• What are the possible short- and long-term outcomes?

When considering the advantages and risks of minimally invasive hip replacement, a surgeon’s experience and success with a specific procedure should be an important factor. More surgical experience is associated with lower complication rates.⁶The Knee Society. Minimally Invasive and Small Incision Joint Replacement Surgery: What Patients Should Consider. PDF. ©2005. http://www.aahks.org/patients/resources/MIS_Patients.pdf accessed via http://www.kneesociety.org/web/weblinks.html. Last reviewed January 2008. Accessed September 17, 2012.^,8Jayankura M, Potaznik A. Total hip arthroplasty by mini-approach: review of literature and experience of direct anterior approach on orthopaedic table. (Abstract only.) Rev Med Brux. 2011;32(6 Suppl):S76-83. Review. French. PubMed PMID: 22458062.

See Choosing a Surgeon for Total Hip Replacement Surgery