Minimally Invasive Hip Surgery

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Minimally Invasive Hip Surgery
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Introduction

• Many people suffering from arthritis alter their
  lives to deal with pain.
• If you havent found relief in medicines,
  exercises, and weight-management, hip replacement
  surgery may be a solution.

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Background on Minimally Invasive Surgery

• A significant advancement in total hip
  replacement
• MIS is not new
• Performed on knees
• Cardiac patients

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What is Minimally Invasive Hip Surgery?

• New surgical technique.
• Uses traditional hip implant components.
• Different techniques, including mini-incision and
  two-incision.

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Difference Between Traditional and Minimally
Invasive Hip Replacement Surgery

• Traditional Hip Replacement Surgery
• Proven in clinical studies and successfully
  performed for decades
• Allows surgeon full visualization of operative
  area
• Larger incision (12-18 inches)
• More disruption of muscles and tissues

• Minimally Invasive Hip Replacement Surgery
• Long-term effects and success are being studied
• Smaller incisions (2-4 inches)
• Potentially less disruption of muscles and
  tissues
• May lead to less blood loss
• Potential for less postoperative pain

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Difference Between Traditional and Minimally
Invasive Hip Replacement Surgery

• Traditional Hip Replacement Surgery
• Average hospital stay is five days
• Average recovery time of approxmiately 3 months
  (individuals will vary)
• Leaves a larger scar on patients thigh

• Minimally Invasive Hip Replacement Surgery
• May lead to a shortened hospital stay
• May reduce recovery time
• Scars will be smaller and less noticeable

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Minimally Invasive Hip Surgery

• Same implants as traditional hip replacement
  surgery.
• Components
• Cup
• Ball
• Stem

Cup
Ball
Stem
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Ideal Candidate for Minimally Invasive Hip
Surgery

• Suffering from hip arthritis and failed to
  respond
• Medicines
• Exercise
• Weight-management programs
• Deciding factors include
• Medical history
• Weight
• General health
• Body structure, including bone structure
• Extent and pattern of arthritis

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Inappropriate Candidates for Minimally Invasive
Hip Surgery

• Severely obese
• Very muscular
• Undergoing complex revision surgeries

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Different Techniques Used for Minimally Invasive
Hip Surgery

• Two-Incision
• 2 incisions
• Approximately 2 inches in length
• On both front and rear of thigh

• Mini-Incision
• 1 incision
• Approximately 3 to 4 inches in length
• Either front or rear of thigh

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Different Techniques Used for Minimally Invasive
Hip Surgery

• Two-Incision
• Estimated 80 mins. To 2 hours
• Fluoroscopy may be used.

• Mini-Incision
• Patients lay on their side.
• Fluoroscopy is not used.

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Surgical Procedure

• Incision is made.
• Socket re-shaped to fit new cup implant replaces
  the diseased socket.
• New cup placed in socket.

Source www.Allaboutarthritis.com, 2003
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Surgical Procedure, continued

• Femur prepared for the stem.
• Hip stem implanted.
• Ball put in place on top of stem.
• Incision is closed.

Source www.Allaboutarthritis.com, 2003
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Benefits of Minimally Invasive Hip Surgery

• Less trauma to the body.
• Healing and rehabilitation potentially quicker.
• Hospital stays can be shorter.
• Allows for immediate stability of the hip.
• Lower risk of dislocation.
• Potentially less postoperative pain.
• Cosmetically appealing.

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Preparing for Minimally Invasive Hip Surgery

• Strength conditioning enhances recovery.
• Strengthen upper body and opposite leg in
  preparation for using crutches.
• Visit a physical therapist to
• Know what to expect in the hospital
• Learn how to protect the hip after surgery
• Get answers to questions about rehabilitation
• Get additional information from
  www.jointreplacement.com in the physical therapy
  section.

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Before Surgery

• Medical evaluation will be completed.
• Alleviate anxiety
• Learning more about what to expect
• Sources
• Patient brochures and videos (distributed by
  doctor)
• Internet education (www.jointreplacement.com)
• Discussion with doctor

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Physical Therapist Role

• The physical therapist will visit the day or day
  after surgery.
• Physical therapist will assess
• Range of motion.
• Ability to move in bed.
• Breathing.
• Ability to bear weight.
• Will help with everyday activity
  evaluation/instruction.
• Using the toilet.
• Bathing.
• Getting in and out of a chair.

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Hospital Discharge General Guidelines

• Accomplish the following activities before
  leaving the hospital
• Walking 100 feet with assistive device.
• Learn to climb stairs safely.
• Exercising independently.
• Equipped with assistive devices such as a sock
  tool, wedge pillow and a raised toilet seat.

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Recovery After Surgery

• The healing hip has a limited range of safe
  motion.
• Follow safety rules, such as
• Not crossing your legs.
• Take care when bending.
• Avoid high-impact and contact sports.
• Follow doctors instructions for a complete
  recovery.

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Potential Complications and Risks

• Factors that may affect the rate of complications
  including.
• The skill of the surgeon.
• Weight, age and overall health of the patient.
• The lifestyle and activities of the patient.
• Presence of osteoporosis or other conditions that
  weaken bones.
• Patient compliance with instructions.

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Potential Complications and Risks, continued

• Hematoma
• Occurs when blood enters the wound after surgery.
  
• If excessive, will be drained.
• Fracture
• From weak bones.
• Patient falls.
• Not following precautions.

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Potential Complications and Risks

• Infection
• Dislocation
• Blood clots

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The Future of Minimally Invasive Hip Surgery

• Evolving
• Clinical evidence is being collected

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Questions?
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Thank You!