Minimally Invasive Hip Replacement Surgery
By John T Dearborn, MD and Alexander Sah, MD
Institute for Joint Restoration and Research
Washington Hospital Healthcare System
If you are suffering from chronic hip pain due to arthritis or traumatic
injury and have tried other treatments such as medications and physical
therapy with no improvement, you might want to investigate whether or
not hip replacement surgery may be an option for you.
With hip replacement surgery, the surgeon removes the damaged joint surfaces
and replaces them with an artificial implant. Years ago, that surgery
entailed an extensive incision, a lengthy hospital stay and months of
rehabilitation. Today, though, minimally invasive hip replacement surgery
techniques dramatically reduce the amount of post-operative pain and significantly
shorten the hospital stay and recovery period.
Traditional Hip Replacement
Traditional hip replacement surgery, in practice since the 1960s in the
United States, has typically utilized an extensive, 5 to 10 inch curved
incision on the side of the hip, extending into the buttock area. The
deep portion of the dissection divides a number of important stabilizing
muscles and tendons and ends with removal of the dense fibrous capsule
of the hip joint. The actual size of the incision depends on the size
of the patient. Although this approach affords wide exposure to the posterior
half of the hip joint, it also leads to a predictably large blood loss
and significant rehabilitation time.
Minimally Invasive Hip Replacement
A handful of hip replacement specialists in this country have developed
specialized techniques and instruments to allow the same operation to
be done with a very limited incision and dissection. The skin incision
is typically two to three inches in length. Direct visualization of the
hip joint is still possible because of special lighting instruments and
retractors. The deep structures, including the capsule, are repaired after
the prostheses have been implanted. This exposure is less extensive, and
therefore surgeons utilize these techniques with special expertise in
hip anatomy and minimally invasive surgery (MIS) techniques.
The advantages of this approach are many, including reduced operative time,
decreased blood loss, fewer postoperative dislocations, reduced pain,
and a faster recovery for the patient. The length of stay in the hospital
has also been reduced to approximately two days. These improvements have
also made hip replacement surgery available to many patients with health
problems severe enough to preclude the traditional procedure.
To gain more knowledge about joint replacement and related therapies, visit