During minimally invasive hip replacement surgery, a surgeon makes a smaller incision and requires a smaller surgical area than during a traditional hip replacement surgery. The result is less cutting of the surrounding skin, muscle and other soft tissue. The hope is that, when performed by an experienced orthopedic surgeon, minimally invasive techniques will allow for an easier recovery in the short term and provide equal or better results in the long term.

Like traditional hip replacement, minimally invasive hip replacement is major surgery that requires cutting and altering of bones and attaching prosthetic joint components. Because minimally invasive surgery must be done with a smaller incision and less of the joint area is exposed, it is considered a technically demanding procedure.

To date, clinical research is mixed, and it is not clear whether minimally invasive hip replacement surgery has an advantage over traditional hip replacement surgery, particularly over the long term1-5 This is an area of ongoing research and an example of how the medical field is continually evolving and trying to improve outcomes for patients. In the meantime, patients and doctors must use the knowledge available to make informed choices, deciding which type of surgery is the best option on a case-by-case basis.

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Goals of minimally invasive hip replacement surgery

The goal of minimally invasive knee replacement surgery is to:

  • Do less damage to the skin by making a smaller incision, typically 3 to 6 inches long, compared to a 10 to 12 inch incision used in traditional surgery. (Alternatively, a 2-incision minimally invasive hip replacement typically involves a 2 to 3 inch incision over the groin and a 1 to 2 inch incision over the buttock.)
  • Leave a smaller scar.
  • Do less damage to the joint’s surrounding muscles and other soft tissue.
  • Reduce the patient’s hospital stay to as few as 1 or 2 days, compared to 3 to 5 days for traditional surgery. In fact, outpatient surgery is now becoming common in select patients undergoing minimally invasive procedures.
  • Enable a patient to rehabilitate faster, reducing the time they must stay in the hospital and accelerating physical therapy.

Some clinical studies suggest that another advantage of minimally invasive surgery is reduced blood loss during surgery, but other studies suggest the opposite.6,7,8 More research is needed on this subject.

Estimated differences in recovery times vary. Generally, experts have found that patients who undergo minimally invasive hip replacement surgery are better able to cope with daily activities a little sooner than people who have had traditional surgery.5 Long-term differences in surgical results are unclear, as they have not been well-studied.

The question of cost savings

Some experts believe minimally invasive surgery cuts down on recovery time and therefore saves money. For example, one study suggests that minimally invasive hip replacement patients typically stay in the hospital for 1.5 days versus 3.8 days for traditional hip replacement surgery, and that shorter hospital stay translates into a hospital cost savings of thousands of dollars per patient.9 However, patients who are covered by Medicare or private insurance might see zero or only a small percentage of out-of-pocket savings.

References:

  1. Jayankura M, Potaznik A. Total hip arthroplasty by mini-approach: review of literature and experience of direct anterior approach on orthopaedic table. (Abstract only.) Rev Med Brux. 2011;32(6 Suppl):S76-83. Review. French. PubMed PMID: 22458062.
  2. Repantis T, Bouras T, Korovessis P. Comparison of minimally invasive approach versus conventional anterolateral approach for total hip arthroplasty: a randomized controlled trial. (Abstract only.) Eur J Orthop Surg Traumatol. 2015 Jan;25(1):111-6. doi: 10.1007/s00590-014-1428-x. Epub 2014 Feb 21. PubMed PMID: 24557411.
  3. Yang B, Li H, He X, Wang G, Xu S. Minimally invasive surgical approaches and traditional total hip arthroplasty: a meta-analysis of radiological and complications outcomes. PLoS One. 2012;7(5):e37947. Epub 2012 May 24. PubMed PMID: 22655086; PubMed Central PMCID: PMC3360020.

Complete Listing of References

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