People who suffer from injuries and degenerative diseases of the hip joint such as osteoporosis may eventually require surgery to restore strength and mobility in one or both hips. Some surgeries involve a total hip replacement--implantation of a prosthetic ball and socket joint in the pelvic region--whereas another type of surgery involves resurfacing worn areas of the thighbone or pelvis. The type of hip replacement surgery performed typically depends on the patient's overall health and on the severity of their joint deterioration.
Traditional Surgery
Traditional or conventional hip replacement surgery involves making a large incision up to 12 inches in length along the side of the hip. The surgeon then detaches muscles, ligaments and tendons, clearing a path to the hip joint. According to the American Academy of Orthopaedic Surgeons, the doctor then removes the ball-like top of the femur, or thighbone, from its socket--a concave spot in the pelvis--and places an implant into the socket. A metal rod implant is then placed into the femur, and a new synthetic ball is fitted to the top of the thighbone. The surgeon then positions the prosthesis back in place to recreate the hip joint.
Minimally Invasive, One-Incision Surgery
Minimally invasive hip replacement surgery is a more contemporary approach to surgery that causes less damage to the muscle tissue surrounding the hip. A minimally invasive, single incision surgical procedure typically involves a smaller cut on the outer hip compared to traditional surgery, usually in the range of 3 to 6 inches, according to the American Academy of Orthopaedic Surgeons. While the surgeon will still cut some muscles and tendons to gain full access to the hip joint, he will repair and reattach these tissues after putting the prosthesis in place. Consequently, patients who undergo minimally invasive, single incision surgeries are more likely to heal faster and spend less time in rehabilitation compared to those who have traditional surgery.
Two-Incision, Muscle Sparing Surgery
While traditional and one-incision hip replacement surgeries require the detachment of muscles in order to reach and operate on the hip joint, two-incision, or muscle sparing, surgery represents a potentially less structurally damaging surgical alternative. Rather than cutting through muscle to get to the hip joint, doctors make two incisions on the front or back of the hip and leave the muscles and surrounding ligaments and tendons untouched while performing surgery on the joint. According to Cedars-Sinai Medical Center, sparing the muscles allows for less blood loss during surgery and a faster, less painful recovery period. The Mayo Clinic notes, however, that this surgery is associated with a higher risk of complications than traditional surgery and muscle damage can occur; therefore, patients should weigh the risks and benefits carefully with their doctors.
Hip Resurfacing
In lieu of a total hip replacement, some patients may be eligible for hip resurfacing--a procedure in which the surgeon covers worn down areas of the hip joint rather than replacing them with a full prosthesis. According to the Mayo Clinic, younger, physically healthy patients who do not have severe hip joint abnormalities or bone weakness may be good candidates for hip resurfacing. While hip resurfacing can spare the patient unnecessary bone loss, it is associated with complications such as fractures of the femoral head; therefore, patients should discuss these concerns with their doctors.
