Minimally Minimally Invasive Hip Invasive Hip

SurgerySurgery

IntroductionIntroduction

Many people suffering from Many people suffering from arthritis alter their lives to deal arthritis alter their lives to deal with pain.with pain.

If you haven’t found relief in If you haven’t found relief in medicines, exercises, and weight-medicines, exercises, and weight-management, hip replacement management, hip replacement surgery may be a solution.surgery may be a solution.

Background on Background on Minimally Invasive Surgery Minimally Invasive Surgery

A significant advancement in A significant advancement in total hip replacement total hip replacement

MIS is not newMIS is not new Performed on kneesPerformed on knees Cardiac patientsCardiac patients

What is Minimally Invasive What is Minimally Invasive

Hip Surgery?Hip Surgery?

New surgical technique.New surgical technique. Uses traditional hip implant Uses traditional hip implant

components.components. Different techniques, including Different techniques, including

mini-incision and two-incision.mini-incision and two-incision.

Difference Between Traditional and Difference Between Traditional and Minimally Invasive Hip Replacement Minimally Invasive Hip Replacement

SurgerySurgery

Traditional Hip Traditional Hip Replacement SurgeryReplacement Surgery Proven in clinical studies Proven in clinical studies

and successfully and successfully performed for decadesperformed for decades

Allows surgeon full Allows surgeon full visualization of operative visualization of operative areaarea

Larger incision (12-18 Larger incision (12-18 inches)inches)

More disruption of muscles More disruption of muscles and tissuesand tissues

Minimally Invasive Hip Minimally Invasive Hip Replacement SurgeryReplacement Surgery Long-term effects and Long-term effects and

success are being studiedsuccess are being studied Smaller incisions (2-4 Smaller incisions (2-4

inches)inches) Potentially less disruption Potentially less disruption

of muscles and tissuesof muscles and tissues May lead to less blood loss May lead to less blood loss Potential for less Potential for less

postoperative painpostoperative pain

Difference Between Traditional and Difference Between Traditional and Minimally Invasive Hip Replacement Minimally Invasive Hip Replacement

Surgery Surgery

Traditional Hip Traditional Hip Replacement Replacement SurgerySurgery Average hospital stay Average hospital stay

is five daysis five days Average recovery Average recovery

time of approxmiately time of approxmiately 3 months (individuals 3 months (individuals will vary)will vary)

Leaves a larger scar Leaves a larger scar on patient’s thighon patient’s thigh

Minimally Invasive Minimally Invasive Hip Replacement Hip Replacement SurgerySurgery May lead to a May lead to a

shortened hospital shortened hospital staystay

May reduce May reduce recovery timerecovery time

Scars will be smaller Scars will be smaller and less noticeableand less noticeable

Minimally Invasive Hip Minimally Invasive Hip SurgerySurgery

Same implants as Same implants as traditional hip traditional hip replacement replacement surgery.surgery.

ComponentsComponents CupCup BallBall StemStem

CupBall

Stem

Ideal Candidate forIdeal Candidate for Minimally Invasive Hip Minimally Invasive Hip

SurgerySurgery Suffering from hip arthritis and failed to Suffering from hip arthritis and failed to

respond:respond: MedicinesMedicines ExerciseExercise Weight-management programs Weight-management programs

Deciding factors include:Deciding factors include: Medical historyMedical history WeightWeight General healthGeneral health Body structure, including bone structureBody structure, including bone structure Extent and pattern of arthritisExtent and pattern of arthritis

Inappropriate Candidates Inappropriate Candidates for Minimally Invasive Hip for Minimally Invasive Hip

SurgerySurgery

Severely obeseSeverely obese Very muscular Very muscular Undergoing complex revision Undergoing complex revision

surgeriessurgeries

Different Techniques Used Different Techniques Used for Minimally Invasive Hip for Minimally Invasive Hip SurgerySurgery

Two-IncisionTwo-Incision 2 incisions2 incisions Approximately 2 Approximately 2

inches in lengthinches in length On both front On both front

and rear of and rear of thighthigh

Mini-IncisionMini-Incision 1 incision1 incision Approximately Approximately

3 to 4 inches in 3 to 4 inches in lengthlength

Either front or Either front or rear of thighrear of thigh

Different Techniques Used Different Techniques Used for Minimally Invasive Hip for Minimally Invasive Hip SurgerySurgery

Two-IncisionTwo-Incision Estimated 80 Estimated 80

mins. To 2 mins. To 2 hourshours

Fluoroscopy Fluoroscopy may be used.may be used.

Mini-IncisionMini-Incision Patients lay on Patients lay on

their side.their side. Fluoroscopy is Fluoroscopy is

not usednot used..

Surgical ProcedureSurgical Procedure Incision is made.Incision is made. Socket re-shaped to Socket re-shaped to

fit new cup implant; fit new cup implant; replaces the diseased replaces the diseased socket.socket.

New cup placed in New cup placed in socket.socket.

Source: www.Allaboutarthritis.com, 2003

Surgical Procedure, Surgical Procedure, continuedcontinued

Femur prepared for Femur prepared for the stem.the stem.

Hip stem implanted.Hip stem implanted. Ball put in place on Ball put in place on

top of stem.top of stem. Incision is closed.Incision is closed.

Source: www.Allaboutarthritis.com, 2003

Benefits of Benefits of Minimally Invasive Hip Minimally Invasive Hip

SurgerySurgery

Less trauma to the body.Less trauma to the body. Healing and rehabilitation Healing and rehabilitation

potentially quicker.potentially quicker. Hospital stays can be shorter.Hospital stays can be shorter. Allows for immediate stability of Allows for immediate stability of

the hip.the hip. Lower risk of dislocation.Lower risk of dislocation. Potentially less postoperative pain.Potentially less postoperative pain. Cosmetically appealing.Cosmetically appealing.

Preparing for Minimally Preparing for Minimally Invasive Hip SurgeryInvasive Hip Surgery

Strength conditioning enhances Strength conditioning enhances recovery.recovery.

Strengthen upper body and opposite leg Strengthen upper body and opposite leg in preparation for using crutches.in preparation for using crutches.

Visit a physical therapist to:Visit a physical therapist to: Know what to expect in the hospitalKnow what to expect in the hospital Learn how to protect the hip after surgeryLearn how to protect the hip after surgery Get answers to questions about rehabilitationGet answers to questions about rehabilitation

Get additional information from Get additional information from www.jointreplacement.comwww.jointreplacement.com in the in the physical therapy section.physical therapy section.

Before SurgeryBefore Surgery

Medical evaluation will be Medical evaluation will be completed. completed.

Alleviate anxietyAlleviate anxiety Learning more about what to expectLearning more about what to expect Sources:Sources:

Patient brochures and videos (distributed Patient brochures and videos (distributed by doctor)by doctor)

Internet education (Internet education (www.jointreplacement.comwww.jointreplacement.com) )

Discussion with doctorDiscussion with doctor

Physical Therapist RolePhysical Therapist Role The physical therapist will visit the day or day The physical therapist will visit the day or day

after surgery.after surgery. Physical therapist will assess:Physical therapist will assess:

Range of motion.Range of motion. Ability to move in bed.Ability to move in bed. Breathing.Breathing. Ability to bear weight.Ability to bear weight.

Will help with everyday activity Will help with everyday activity evaluation/instruction.evaluation/instruction. Using the toilet.Using the toilet. Bathing.Bathing. Getting in and out of a chair.Getting in and out of a chair.

Hospital Discharge Hospital Discharge General GuidelinesGeneral Guidelines

Accomplish the following activities Accomplish the following activities before leaving the hospital:before leaving the hospital: Walking 100 feet with assistive device.Walking 100 feet with assistive device. Learn to climb stairs safely.Learn to climb stairs safely. Exercising independently.Exercising independently. Equipped with assistive devices such as Equipped with assistive devices such as

a sock tool, wedge pillow and a raised a sock tool, wedge pillow and a raised toilet seat.toilet seat.

Recovery After SurgeryRecovery After Surgery

The healing hip has a limited range The healing hip has a limited range of safe motion.of safe motion.

Follow safety rules, such as:Follow safety rules, such as: Not crossing your legs.Not crossing your legs. Take care when bending.Take care when bending.

Avoid high-impact and contact Avoid high-impact and contact sports.sports.

Follow doctor’s instructions for a Follow doctor’s instructions for a complete recovery.complete recovery.

Potential Complications Potential Complications and Risksand Risks

Factors that may affect the rate of Factors that may affect the rate of complications including.complications including. The skill of the surgeon.The skill of the surgeon. Weight, age and overall health of the Weight, age and overall health of the

patient.patient. The lifestyle and activities of the patient.The lifestyle and activities of the patient. Presence of osteoporosis or other Presence of osteoporosis or other

conditions that weaken bones.conditions that weaken bones. Patient compliance with instructions.Patient compliance with instructions.

Potential Complications Potential Complications and Risks, continuedand Risks, continued

HematomaHematoma Occurs when blood enters the wound Occurs when blood enters the wound

after surgery. after surgery. If excessive, will be drained.If excessive, will be drained.

FractureFracture From weak bones.From weak bones. Patient falls.Patient falls. Not following precautions.Not following precautions.

Potential Complications Potential Complications and Risksand Risks

InfectionInfection DislocationDislocation Blood clots Blood clots

The Future of Minimally The Future of Minimally Invasive Hip SurgeryInvasive Hip Surgery

EvolvingEvolvingClinical evidence is being Clinical evidence is being

collectedcollected

Questions?Questions?

Thank You!Thank You!