Orthopedic surgeons have adopted new technologies that allow hip replacements to be done using small incisions. Besides the attraction of having a much smaller scar, this surgery, called minimally invasive surgery, or MIS, has less blood loss, requires fewer days in the hospital, has a shorter recovery time and may be less painful. It is, however, generally only done on younger, healthier people who are not overweight. Johns Hopkins Medicine reports on a study showing that outcomes for traditional and MIS surgeries are about the same at one year post-operatively. Longer term studies are not yet available, because MIS for hip replacement is a relatively new technique. While MIS has many advantages, it still has many of the same potential complications as traditional total hip arthroplasty.
Nerve and Artery Injuries
As with many other types of surgery, nerves and arteries surrounding the surgical site are at risk of sustaining damage with MIS. The technologies that support minimally invasive hip replacement surgery, the techniques for using those technologies most effectively and the research to track its results are still evolving. For these reasons, Johns Hopkins and others recommend seeking an orthopedic surgeon who is experienced in this technique to reduce the potential for complications from nerve or artery injuries.
Blood Clots
Blood clots are a possible complication after most surgeries, including minimally invasive hip replacement surgery. It's important to follow any guidance provided by the orthopedic surgeon, such as taking blood-thinning medications and getting moving as soon as possible, to help prevent this potentially life-threatening complication.
Infection
One of the most common complications after hip replacement surgery, even MIS, is getting an infection at the surgical site. However, according to the Centers for Disease Control and Prevention, of the more than 4 million orthopedic surgeries performed in the U.S. each year, only about 1 percent become infected. Infections can occur long after such a surgery, as bacterial from dental procedures, urinary tract infections or skin infections may settle around the hip prosthesis. The American Academy of Orthopaedic Surgeons recommends that anyone who's had a hip replacement take an antibiotic before having dental work done.
Dislocation
In traditional hip replacement surgery, patients were expected to limit the initial range of motion of the new hip. These precautions were designed to keep the hip from dislocating. Smaller incisions, a hallmark of minimally invasive hip replacements, aren't only through the skin but also through the hip musculature. By limiting the extent of muscle involvement, patients have fewer restrictions, and there is a reduced chance of hip dislocation. However, the placement of the prosthesis using the MIS technique requires experience. Poor placement can eventually cause the prosthesis to wear improperly, to become loosened or even to dislocate.
References
- Johns Hopkins Medicine: The Pros and Cons of Minimally Invasive Hip-Replacement Surgery
- University of Connecticut Health Center: Minimally Invasive Hip Replacement
- Centers for Disease Control and Prevention: Surgical Site Infection FAQ
- AAOS: Total Hip Replacement
- International Orthopaedics: The Impact of Minimally Invasive Total Hip Arthroplasty on the Standard Procedure
