Research on minimally invasive hip replacement surgery is mixed, and it is not clear whether it has an advantage over traditional hip replacement surgery.1-6 This area of ongoing research is an example of how the medical field is continually evolving and trying to improve outcomes for patients.
In the meantime, people considering hip replacement surgery and their surgeons must make decisions based on the information available.
Minimally Invasive Hip Replacement Surgery
There is no single way to perform a minimally invasive hip replacement. Because of the limited research available, all minimally invasive techniques are grouped in this section. Typically, minimally invasive hip replacement surgery requires a single 3- to 6-inch incision or two smaller incisions.
The minimally invasive approaches to hip replacement may provide:
- Smaller scar
- Less damage to surrounding soft tissue
- A faster rehabilitation,7-8 though research in this area is mixed5,9,10
- Less blood loss6
It is not clear if the reduced blood loss is enough to offer meaningfully better results for patients.5
Concerns about the minimally invasive approaches to hip replacement include:
- The surgeon has a limited view of the joint, making it more challenging for a surgeon to create a perfect fit and alignment for the hip replacement components
- Skin and soft tissue can be stretched and torn during surgery
- Possible increased likelihood of nerve damage6
Despite these potential disadvantages, most minimally invasive total hip replacements have successful outcomes.
Who can have minimally invasive hip replacement surgeryPatients must be healthy enough to undergo major surgery and be able to follow-through with pre- and post-surgical instructions. In addition, evidence seems to indicate that the best candidates—
- Are younger
- Are relatively thin, not obese or very muscular
- Lack any bone or joint deformities
- Have not had previous hip surgery
- Do not have osteoporosis; osteoporosis increases the chance of bone breakage
Many patients will not meet these requirements.
Traditional Hip Replacement Surgery
Most hip replacements are traditional hip replacements. During this surgery, a surgeon makes a 6- to 10-inch incision and has a clear view of the hip joint to be operated on.
Traditional approaches to hip replacement tend to:
- Use reliable and time-tested surgical techniques
- Provide the surgeon with a clear view of the hip joint, which may help them create an ideal fit and alignment
When the new hip’s components are well aligned, the chances for good pain relief and function improve and the likelihood of certain post-surgical complications occurring is reduced.
When compared with minimally invasive surgery, traditional hip replacement is associated with:
- More damage to surrounding muscles and other soft tissues
- A slower recovery
- A larger scar
More tissue is cut during traditional surgery, so more healing needs to take place.
Who can have traditional hip replacementAs with minimally invasive surgery, traditional hip replacement patients must be healthy enough to undergo major surgery and be able to follow through with pre- and post-surgical instructions. In addition, candidates typically:
- Are subject to less stringent weight requirements
- Can have mild to moderate osteoporosis
People with severe osteoporosis are typically not eligible for any joint replacement surgery.
Hospital Stays Are About the Same
Hospital stays for traditional hip replacement have decreased in recent years, averaging about 1 to 2 days, with many patients being discharged in less than 24 hours.11 Research6 suggests the average hospital stays for minimally invasive hip replacement surgeries are about the same.
Cost Savings Vary
Some people believe minimally invasive hip replacement surgery cuts down on recovery time and therefore saves money. While this may be true, patients who are covered by Medicare or private insurance might see little to no out-of-pocket savings.
Patients may opt for minimally invasive surgery hoping they can return to work sooner, minimizing their financial burden. However, returning to work sooner is not guaranteed. A person’s return to work is dependent on the individual’s unique recovery as well as the type of work they do.