Question:I've heard there's a new way to put a total hip joint in with only two small incisions. Can anyone getting a total hip have this type of operation?
Answer:When two-small incisions are made for a total hip replacement (THR), the operative technique is called minimally invasive (MI). Many studies have been done to see if there is any advantage to doing it this way.
Some studies show the long-term results aren't really any better than with a larger incision. The MI method is much more difficult for the surgeon. Using the MI approach requires more training and practice on the part of the surgeon. Early cases in the surgeon's training tend to have much higher complications and problems compared to patients treated much later.
There are a few conditions that may keep a patient from having a MI THR. The first is hip dysplasia. This is a deformity of the hip with a shallow acetabulum (hip socket). There's a tendency for the head of the femur to slip up and out of the socket.
You may be excluded from having a MI THR if you already have plates, screws, or other hardware in the hip or pelvis. It may be necessary to remove these pieces before the THR can be done.
With minimal visibility, it's more difficult for the surgeon to match the right size implant to the patient's hip. It is also more challenging to insert the component parts with the correct angle and rotation. Extreme obesity may be a problem if the large abdomen hangs over the surgical site.
Otherwise the two-incision MI procedure can be done on most patients with degenerative hip disease needing a THR.B. Sonny Bal, MD, MBA, et al. Early Complications of Primary Total Hip Replacement Performed with a Two-Incision Minimally Invasive Technique. In The Journal of Bone & Joint Surgery. September 2006. Vol. 88-A. Supplement 1, Part 2. Pp. 221-233.
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