Minimally invasive hip arthroplasty uses a laparoscope to remove a damaged or diseased hip joint and replace it with hardware. This approach usually improves recovery time versus an open hip replacement surgery.
Hip arthroplasty is also called hip replacement surgery. The hip consists of a ball (femoral head) that fits into a socket (acetabulum). The joint capsule and surrounding ligaments and muscles provide stability to the joint.
Hip arthroplasty surgery involves the removal of damaged parts of the hip joint and replacing them with parts constructed with metal, ceramic and very hard plastic. This artificial joint is also called a prosthesis or an implant. It helps reduce pain and improves hip joint function. Hip arthroplasty is indicated when the hip joint is damaged. Arthritis is the most common cause of hip joint damage and, hence, one of the most common indications for hip arthroplasty.
Compared with conventional surgical approaches, total hip arthroplasty (THA), also called total hip replacement (THR), can be performed via minimally invasive surgery. In minimally invasive THR (MIS-THR), smaller skin incisions are used and fewer soft tissues and the damaged bone around the hip are cut. This may lead to a shorter recovery time. The choice of technique depends on the surgeon’s decision.
Why is a minimally invasive total hip replacement surgery done?
Surgery is indicated when the pain is severe and interferes with routine activities such as sleep. Ideally, MIS-THR is considered when there is little or no anatomic deformity of the femoral head and acetabulum.
Degenerative arthritis of the hip can often be initially managed medically with exercise, physical therapy, painkillers and alternative pain management techniques. If medical therapy fails, then surgical therapy can be considered.
When is a minimally invasive total hip replacement surgery avoided?
There are no absolute contraindications for MIS-THR, but conventional hip replacement surgery is preferred in patients who have:
- Pathologic conditions that require a wider exposure
- Revision hip arthroplasty
- Previously undergone certain surgical procedures for fractures and other conditions
- Bony ankylosis
- Rheumatoid arthritis
- Patients with a body mass index (BMI) higher than 30
- Severe hip contracture (inability to fully extend the hip)
In addition, conventional hip replacement surgery is more suitable for patients who are overweight and those who are very muscular.
How is a minimally invasive total hip replacement surgery performed?
- Prior to surgery, the surgeon performs a complete physical assessment and might ask additional tests that include X-ray and magnetic resonance imaging (MRI) of the joint to get detailed information about your hip.
- The surgery is performed under general anesthesia.
- The surgeon makes two small incisions approximately 2-inch long.
- The damaged joint is removed and replaced with a prosthetic joint.
- The surgical wound is closed with sutures (stitches) and dressed.
How long does it take to recover from a minimally invasive total hip replacement?
- After the surgery, painkillers and antibiotics are administered.
- Patients are usually discharged within one to three days after the surgery.
- They are encouraged to walk with support the same or the next day to prevent the formation of blood clots.
- Physical therapy may begin at the hospital, and the patient is advised to continue the exercises at home.
- Pain, swelling and bruising due to surgery reduce in two weeks.
- Most patients can resume their routine activities in six to12 weeks.
- Complete recovery after surgery may take six to 12 months; after that patients can resume high-impact exercises and sports.
What are the complications of a minimally invasive total hip replacement?
Some complications of minimally invasive total hip replacement are:
- Osteolysis (inflammation destroying the bone and causing the prosthesis to loosen)
- Blood clot formation,
- Bone necrosis (bone death)
- Different leg lengths leading to altered gait/ limp
- Migration or failure of prosthesis
- Dislocation or fracture of the joint
- Fractures around the joint
- Reaction to anesthesia