The prospect of undergoing a total hip replacement can be worrisome for some patients. Even though it’s a common orthopedic procedure, the traditional surgical approach to total hip replacement involves making a long incision – 10 to 12 inches long – to replace the hip joint with an implant or “prosthesis” to relieve pain and improve your mobility.
However, there is a minimally invasive variation to this approach in which one or two shorter incisions can be made as a means of reducing pain and allowing a speedier recovery.
For those facing a total hip replacement, a minimally invasive option may be worth talking to their surgeon about. Here’s why.
Approaches to Hip Replacement
During any hip replacement surgery, damaged bone and some soft tissue are surgically removed. The difference is that with minimally invasive surgery, fewer muscles around the hip are cut or detached due to the smaller incision. Nevertheless, both traditional and minimally invasive surgery are technically complex and require surgical expertise to produce effective outcomes.
Traditional Total Hip Replacement.
During a traditional hip replacement procedure, the surgeon makes a longer incision on the side of the hip. He then splits or detaches the muscles from the hip to expose and dislocate the hip. The damaged femoral head is replaced with a metal stem placed into the hollow center of the femur. Next, a metal or ceramic ball is installed on the upper part of the stem, replacing the damaged femoral head that has been removed. In addition, the damaged cartilage surface of the socket is replaced with a metal socket, sometimes secured with screw or cement. To conclude, a spacer is inserted between the ball and the socket. The spacer is made of either plastic, ceramic or metal, and is used to create a smooth, gliding surface.
Minimally Invasive Total Hip Replacement.
With minimally invasive total hip replacement surgery, the procedure is similar to the traditional approach but involves less cutting of the tissue that is adjacent to the hip. The same artificial implants as those used in traditional hip replacement are used in minimally invasive total hip replacement, however, the latter requires specially designed surgical instruments to prime the socket and femur and properly position the prosthesis.
The procedure can be performed with either one or two small incisions to allow for less tissue intrusion. The surgeon can make a single incision measuring three to six inches, depending on the patient’s size and the amount of difficulty. The incision is usually located over the outside of the hip and, although muscles and tendons are split or detached, it is done to a lesser extent than with traditional hip replacement surgery. Once the implants are installed, the muscles and tendons can be repaired to encourage healing and to help prevent dislocation of the hip.
If the surgeon makes two incisions, one is two to three inches long and done over the groin to enable placement of the socket, and the other incision is only one to two inches long and done over the buttock to allow placement of the femoral stem. Often, the surgeon performing a two-incision procedure relies on guidance from x-rays and the operation may take longer than traditional hip replacement surgery.
Expectations After Hip Replacement Surgery
After any type of hip replacement surgery, you may need to stay in the hospital for observation. Expect to be prescribed a series of physical therapy sessions where your therapist will instruct you on specific exercises aimed at increasing your range of motion and restoring your strength.
Dr. Bill Hefley and his caring staff are devoted to treating a broad range of conditions affecting the shoulder, hip, and knee, both operatively and nonoperatively. If you have any questions about hip replacement or any other orthopedic concerns, please contact us to schedule an appointment. You can call (800) 336-2412 or simply use our online request form.