Minimally Invasive Hip Replacement
Total hip replacement is a common procedure. It involves removing the head of the thighbone (femur). The ball-and-socket mechanism of the hip is replaced with artificial implants.

As the population ages over the next decade, this procedure is expected to become even more common. Patients who undergo hip replacement are typically 60 to 75 years old. More than 90 percent of hip replacements last for 10 years or more. Pain and mobility improve after hip replacement. This allows patients to maintain their independence and quality of life.

Newer techniques and implants have been developed. They make hip replacement a less invasive operation. It takes less time for the patient to recover from surgery. The new implants are engineered to last longer.
 
Traditional Hip Replacement: The doctor may recommend hip replacement when all of the above measures have been considered or have been tried and failed. Traditional hip replacement surgery involves making a 10-inch to 12-inch incision on the side of the hip. The muscles are split or detached from the hip. The hip is dislocated. The ball of the femur is removed. The hip socket is prepared by removing any remaining cartilage and some of the surrounding bone. The cup implant is pressed into the bone of the socket. It may be secured with screws. A bearing surface is inserted into the socket.

Next, the femur is prepared by removing some bone from the inside of the thighbone. A metal stem is placed into the thighbone to a depth of about 6 inches. The stem implant is either fixed with bone cement or is implanted without cement. Cementless implants have a rough, porous surface. It allows bone to adhere to the implant to hold it in place. A ball is then placed on the top of the stem. The ball-and-socket joint is recreated.

Minimal Incision Hip Replacement: Minimal incision hip replacement surgery lets the surgeon perform hip replacement through one or two smaller incisions. Compared with most people getting hip replacements, candidates for minimal incision procedures are typically thinner, younger, healthier and more motivated to have a quick recovery. Before you decide to have a minimally invasive hip replacement, get a thorough evaluation. Discuss the risks and benefits.

The artificial implants used for the minimally invasive hip replacement procedures are similar to those used for traditional hip replacement. The artificial hip is implanted in the same way. But there is less soft-tissue dissection than with longer incisions.
 
A single minimally invasive hip incision may measure only 3-inches to 6-inches. It depends on the size of the patient and the difficulty of the procedure. The incision is usually placed over the outside of the hip. The muscles and tendons are split or detached, but to a lesser extent than in the traditional hip replacement operation. They are routinely repaired after placing the implants. This helps healing. It helps prevent dislocation of the hip.

Two-incision hip replacement involves making a 2-inch to 3-inch incision over the thigh for placement of the socket and a 1-inch to 2-inch incision over the buttock for placement of the stem. To perform the two-incision procedure, the surgeon needs guidance from X-rays. It may take longer to perform this surgery, than to perform traditional hip replacement surgery.

Reported benefits of less invasive hip replacement include:

Less pain

More cosmetic incisions

Less muscle damage

Rehabilitation is faster

Hospital stays are shorter--For traditional hip replacement, hospital stays average four to five days. Many patients need extensive rehabilitation afterward. With less invasive procedures, the hospital stay may be as short as one or two days. Rehabilitation is required after both types of hip replacement.

Discuss with your doctor the benefits of minimally invasive surgery, and see if it is an option for you. 

Reviewed March 2007