
Minimally Invasive Knee Arthroplasty and Classic(MIS)
Introduction
Total hip arthroplasty is a common orthopedic procedure, and as the population ages, it is expected to become even more common. It is performed to replace damaged or worn articular surfaces of the hip. Replacing these surfaces with prostheses will relieve pain and increase mobility, allowing a return to daily activities. The standard approach to hip arthroplasty uses a long incision to access the articular surfaces. Minimally invasive total hip arthroplasty is a variation of this approach, and can be performed with one or two incisions. The orthopedic surgeon uses a smaller incision and a less invasive technique to reach the joint, with the goal of reducing postoperative pain and speeding up recovery. Unlike the standard technique of total hip replacement, the minimally invasive technique is not suitable for all patients. Your orthopedic surgeon will discuss with you the various surgical options that may be applicable to you.
Minimally Invasive Knee Arthroplasty and Classic(MIS)
During hip arthroplasty, the damaged bone is cut and removed, along with some soft tissue. In minimally invasive hip arthroplasty, the surgical procedure is similar to the standard technique, except that the incision is about half as long and fewer muscles are cut and detached. The prostheses applied are the same, but specially designed tools are used to prepare the femur and the acetabulum and the to position the prostheses correctly.
Minimally invasive hip arthroplasty can be performed through either one or two small incisions. Smaller incisions result in less injury to the surrounding soft tissues.
• Single incision surgery. In this type of minimally invasive hip arthroplasty, the orthopedic surgeon makes an incision that usually ranges from 8 to 12cm. The length of the incision depends on the patient's body type and the difficulty of the surgery. The incision is usually made on the lateral or anterior surface of the hip. Muscles and tendons are opened or detached, but to a lesser extent than in standard hip arthroplasty and are usually repaired after the prostheses are placed. This promotes healing and prevents dislocation of the hip.
• Two-incision surgery. In this type of minimally invasive hip replacement, the orthopedic surgeon makes two small incisions:
-
A 6cm incision on the anterior surface of the hip to place the acetabulum and
-
A 4cm incision on the posterior surface of the hip for the placement of the femoral stem.
For the 2 incision-technique, the orthopedic surgeon may need an X-ray machine. It may take a little longer for the 2 incision procedure than for the standard hip replacement.
Because the minimally invasive techniques used to access the joint cause less damage to the muscles, they may result in less postoperative pain and reduced recovery time. The length of hospital stay ranges from 1 to 4 days.
Candidates for minimally invasive knee arthroplasty
Minimally invasive hip arthroplasty is not suitable for all patients. Your orthopedic surgeon will perform a detailed assessment and evaluate a number of factors before determining if this technique is an option for you. Generally, candidates for minimally invasive hip arthroplasty are patients who are thinner, younger, in better health, and more willing to participate in rehabilitation programs.
This technique may be less suitable for patients who are overweight or who have already undergone other hip procedures. In addition, patients with significant deformity in the hip, or very muscular patients, or patients with health problems that may slow wound healing, may be at higher risk for problems from minimally invasive hip arthroplasty.
Conclusion
Minimally invasive hip arthroplasty is an evolving field and more research is needed in relation to long-term outcomes and durability of materials/prostheses.
The advantages of minimally invasive surgery have included less soft tissue injury, less postoperative pain and faster recovery and return to daily activities.
According to existing scientific data, the long-term results of hip arthroplasty with minimally invasive technique are no different from those with standard technique.
Like all surgical procedures, the minimally invasive surgical technique has potential complications. These include nerve and artery injury, wound problems, infection, misplacement of materials and fractures.