During any hip replacement surgery, the damaged bone is cut and removed, along with some soft tissues. In minimally invasive surgery, a smaller surgical incision is used and fewer muscles around the hip are cut or detached.
Despite this difference, however, both traditional hip replacement surgery and minimally invasive surgery are technically demanding and have better outcomes if the surgeon and operating team have considerable experience.
To perform a traditional hip replacement:
- A 10- to 12-inch incision is made on the side of the hip. The muscles are split or detached from the hip, allowing the hip to be dislocated and fully viewed by the surgical team.
- The damaged femoral head is removed and replaced with a metal stem that is placed into the hollow center of the femur, then a metal or ceramic ball is placed on the upper part of the stem. This ball replaces the damaged femoral head that was removed.
- The damaged cartilage surface of the socket (acetabulum) is removed and replaced with a metal socket. Screws or cement are sometimes used to hold the socket in place.
- A plastic, ceramic or metal spacer is inserted between the new ball and the socket to allow for a smooth gliding surface.
In minimally invasive total hip replacement, the surgical procedure is similar, but there is less cutting of the tissue surrounding the hip. The artificial implants used are the same as those used for traditional hip replacement. However, specially designed surgical instruments are needed to prepare the socket and femur and to place the implants properly.
Minimally invasive total hip replacement can be performed with either one or two small incisions. Smaller incisions allow for less tissue disturbance.
- In this type of minimally invasive hip replacement, the surgeon makes a single incision that usually measures from 3 to 6 inches. The length of the incision depends on the size of the patient and the difficulty of the procedure.
- The incision is usually placed over the outside of the hip. The muscles and tendons are split or detached from the hip, but to a lesser extent than in traditional hip replacement surgery. They are routinely repaired after the surgeon places the implants. This encourages healing and helps prevent dislocation of the hip.
- In this type of minimally invasive hip replacement, the surgeon makes two small incisions.
- A 2- to 3-inch incision over the groin for placement of the socket, and
- A 1- to 2-inch incision over the buttock for placement of the femoral stem.
To perform the two-incision procedure, the surgeon may need guidance from x-rays. It may take longer to perform the two-incision surgery than it does to perform traditional hip replacement surgery.
The hospital stay after minimally invasive surgery is similar in length to the stay after traditional hip replacement surgery–ranging from 1 to 4 days. Physical rehabilitation is a critical component of recovery.
Your surgeon or a physical therapist will provide you with specific exercises to help increase your range of motion and restore your strength.