What is minimally invasive hip replacement?

Minimally invasive surgery involves performing total hip replacement through a smaller skin incision, minimal soft tissue dissection and the restoration of soft tissue anatomy. The incision is typically three to five inches long and the muscles are preserved to achieve a good hip function as much as possible. A better understanding of anatomy and an evolution in the surgical technique and instruments have enabled surgeons to perform hip replacements through minimally invasive technique safely.

Total hip replacement can be done through an incision at the back, side or front of the hip. Minimally invasive hip replacement is commonly performed through an incision on the back (posterior approach) or front (anterior approach) of the hip. Each has its own advantages and disadvantages, but there is no evidence so far that overall, one is better than the other. Each surgeon chooses the approach they feel will best achieve good results for their patients.

How does minimally-invasive hip replacement surgery differ from more traditional procedures?

Minimally-invasive hip replacement surgery is defined by the very small incision (less than ten centimetres) used to perform the procedure. The most important thing about hip surgery is not just the length of the incision but also the muscles and tissues which are damaged in the operation.

When I perform surgery, I do so without cutting the major muscles which we rely on when walking or running. This should ensure a better result, less chance of limping after surgery and a faster return to normal function. The ultimate aim is to get something called ‘the forgotten joint’, meaning that after recovery, when a patient is asked which hip they have had replaced, they have to think about it for a second because one hip feels just like the other.

How long does it take to perform minimally-invasive hip replacement surgery?

It typically takes just over an hour to perform a minimally-invasive hip replacement. This type of surgery involves slightly different instruments which allow us to access the hip without having to dissect as much soft tissue as in traditional procedures. Hopefully, this should result in a quicker recovery and fewer problems after the surgery.

How long does it take to recover from minimally-invasive hip replacement surgery?

My patients go home at a variety of times after the surgery. Some even go home on the same day but that’s by no means standard. Most people are at home by day two following hip replacement surgery but some people may want to stay for three days. At that stage, they should be able to walk with two sticks and go up and down stairs and self-care.

By six weeks, when I next see the patient, I expect them to be walking without any aids and doing most things. I ask my patients to be careful with their hip for the first few months because that is the time when everything is healing it is at most risk. Patients can usually to return to normal activities by three months. Although patients are able to do most activities, I would probably warn them against some positions in yoga, for example.

What are the advantages of minimally-invasive hip replacement surgery?

The advantages are that you have a smaller scar, less soft tissue dissection and you should have a quicker recovery.

Are there any disadvantages of minimally-invasive hip replacement surgery?

Performing minimally-invasive surgery does pose a technical challenge so it’s important to see an experienced specialist.

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