Minimally Invasive Surgery

Small Incisions Offer Big Potential Benefits

Two of the most significant advances in total hip replacement are the most prominent minimally invasive techniques—mini-incision and direct two-incision. Minimally invasive hip replacement allows surgeons to implant traditional hip components through one or two small (1.5 to 4 inch) incisions rather than the traditional 10 to 12 inch incision. The goal of minimally invasive hip replacement is to minimize the amount of soft tissue damage that occurs when a surgeon reconstructs a hip. The potential benefits of this approach include:

• Less bleeding during surgery
• Less post-operative pain
• Shorter recovery time
• Smaller scars for improved cosmetics

The Mini-Incision Technique
The mini-incision technique is similar to the traditional hip replacement, but the one skin incision made is very small (3 to 4 inches). Through careful positioning of the surgical incision, trauma to soft-tissue structures such as skin and muscle can be reduced through the mini-incision technique. Because less skin, muscle, and other soft tissues are involved, patients can potentially recover quicker, spend fewer days in the hospital, and return to their active lives sooner.

The Direct Two-Incision Technique
Because of the small exposure associated with preparation of the femoral canal (leg bone) with the small incision technique, the two-incision approach was developed to provide more precision in preparing the femoral (leg bone) canal for the new ball component. This technique uses one incision for preparing and inserting the socket. The second incision is used to prepare and insert the thighbone component. Only one muscle structure is cut, while other soft tissue structures such as ligaments and tendons are moved aside instead of being cut. In addition, another important benefit of this technique is the sparing of the fascia latae (deep sheet tissue surrounding the thigh muscle). As a result, this may reduce the occurrence of localized pain over the greater trochanter and provide greater hip stability immediately after surgery. 

The performance of a hip replacement depends on your age, weight, activity level and other factors. There are potential risks, and recovery takes time. People with conditions limiting rehabilitation should not have this surgery. Only an orthopaedic surgeon can determine whether you are a candidate for the minimally invasive hip replacement procedure. Also, a mini-incision may need to be converted into a traditional incision during surgery. There are many surgeons that may still prefer to perform traditional hip replacement surgery.

Next: Recovery and Rehabilitation