Minimally invasive hip replacement

Minimally invasive hip replacement surgery (MIS) has received a lot of attention over the last 15 years, and has revolutionised the treatment of patients requiring hip replacements.

The most important aspect of MIS is that there is minimal damage to the structures around the hip, minimising soft tissue injury, and maximising recovery and function. It has inevitably been associated with smaller skin incisions, but it is what happens inside that really matters and good implant placement and maximising the longevity of the hip replacement must never be put at risk for the sake of a small scar.

Fig 1: Standard and MIS scars for total hip replacement.

Various techniques have been developed including posterior MIS approach, lateral and anterior. All techniques have their own strengths and weaknesses. Orthopaedics WA has been involved with MIS hip replacement surgery for over 15 years and he will nearly always use the muscle sparing mini posterior approach.

Fig 2: Mini posterior deep dissection.

Orthopaedics WA believe that the advantages of this approach are:

Excellent exposure allowing optimal implant placement, optimising longevity of the hip replacement and minimising dislocation.
Minimal muscle damage, with no interference with the walking muscles, and the lowest potential for nerve injury. This leads to minimal blood loss, better immediate function, and less limp.
The approach can be extended fully if there is a problem during or subsequent to the surgery.

The development of MIS surgery has led to the re-evaluation of all the things we do associated with hip replacement surgery. Changes to anaesthetics, blood management, patient and staff education, and hospital practices has led to a dramatic reduction in hospital stay, reduced complications and improved outcomes.

Our routine hip replacement patients will usually be able to go home on the second to third day post operatively, (although individual requirements vary).

Fig 3: Patient walking on day of surgery.