Overview
Hip replacement surgery is one of the most successful modern orthopedic surgical procedures. (Orthopedics is the branch of medicine dealing with bones.) Hip replacement surgeries use modern biomaterials. Biomaterials are synthetic or partially synthetic materials that are used to take the place of parts within the body. Use of these modern materials has allowed hip replacements to last well in appropriately selected patients. However, pain and other side effects associated with the surgical procedures remain a concern for many people.
New and improved anesthesia techniques, as well as pain management medications and methods, have reduced pain and improved recovery after hip replacement surgery. Any method of speeding up recovery after surgery is desirable, as many people are anxious to return to their day-to-day activities.
Minimally invasive hip replacement surgery is a general term that describes several variations of existing surgeries. Minimally invasive techniques are designed to reduce the tissue trauma associated with hip replacement. The surgery is performed with smaller incisions. Less trauma to the tissues results in less postoperative discomfort and quicker recovery.
When to Seek Medical Care ?
In general, hip replacement surgery should be sought only for debilitating pain that does not improve with pain medications, exercise, weight loss, and reasonable activity modification. Hip replacement, regardless of surgical technique, is a major operation for a worn-out joint that cannot function any longer. Hip replacement surgery involves lifestyle changes and an artificial joint. No artificial hip can ever be a perfect substitute for a real hip. Optional surgery, such as hip replacement, should be avoided until other treatment options have failed.
Minimally Invasive Hip Replacement Preparation
Being educated about what to expect is important after minimally invasive hip replacement surgery. Candidates for the procedure are educated on both the benefits and the risks of minimally invasive hip replacement surgery. The patient and his or her doctor determine if this procedure is right for them. The term minimally invasive surgery is somewhat misleading. It is still a surgery, and any type of surgery is invasive.
The human response to injury is predictable, and it includes discomfort, altered emotions, and a period of recovery until healing occurs. Minimally invasive surgery can reduce, but not eliminate, these normal responses to the trauma of surgery. Minimally invasive surgery also does not mean risk-free surgery. Hip replacement surgery, regardless of technique, is associated with risk of infection, nerve injury, deep blood clots, premature implant loosening and failure, unpredictable medical complications, and even death. While these complications are uncommon, one needs to be aware of them before embarking on any type of hip reconstructive procedure.
During the Procedure
During some minimally invasive hip replacement surgery procedures, the person lies on one side. However, in the MIS-2-incision hip replacement procedure, the person lies flat on his or her back. Fluoroscopy is used to precisely guide the placement of the incision. Special instruments are used to make the small incisions. Also, the implants are slightly different in design than the implants that are used during a standard hip replacement surgery.
After the Procedure
Many surgeons combine a small incision with spinal and epidural anesthetics to facilitate recovery. Newer anesthesia drugs reduce the nausea and confusion experienced upon awakening. Local anesthesia injected into the surgical site relieves pain after surgery.
With current minimally invasive techniques, the person is encouraged to become mobile much earlier than with standard methods of hip replacements. Many people are able to get out of bed either the same day or the next day, with the help of a physical therapist.
Pain pumps that infuse painkillers into the incision, patient-controlled analgesics, and newer antiinflammatory drugs may all be combined to speed recovery.
Risks
Every surgery has risks. Minimally invasive surgery is still associated with complications, such as the following:
- Improper placement of the components
- Nerve injury
- Fractures during the procedure
- Blood loss
- Blood clots after surgery
- Infection after surgery
Results
Minimally invasive hip replacement surgery is a new procedure. Short-term results are promising. Surgeons are gaining more experience with these new techniques. If the implants are placed properly, the new hip should last through several decades of reasonable use, as long as precautions and activity recommendations given by the surgeon are followed.
Minimally invasive hip replacements allow earlier discharge from the hospital, less pain, and faster return to the activities of daily living. Less physical therapy is needed after discharge. However, there are specific complications for any new procedure. The experience of the surgeon is also a factor. Surgeon selection and patient education are very important when it comes to new technology in surgery.
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