Minimally Invasive Total Hip Replacement
Over the past several years, orthopedic surgeons have been developing new minimally invasive surgical techniques for inserting total hip replacement implants through smaller incisions.
It is hoped, but not yet proven, that this may allow for quicker, less painful recovery and more rapid return to normal activities. Minimally invasive and small incision total hip replacement surgery is a rapidly evolving area. Although certain techniques have proven to be safe, others may be associated with an increased risk of complications, such as nerve and artery injuries, wound healing problems, infection, fracture of the femur, and malposition of the implants, which can contribute to premature wear, dislocation, and loosening of your hip replacement.
Patients who have marked deformity of the joint, those who are heavy or muscular, and those who have other health problems that can contribute to wound healing problems appear to be at higher risk of problems.
Your orthopedic surgeon can talk to you about his or her experience with minimally invasive hip replacement surgery and the possible risks and benefits. The AAOS and the American Association of Hip and Knee Surgeons have developed information for patients about minimally invasive hip replacement surgery.
Possible Hip Surgery Complications
The complication rate following hip replacement surgery is low. Serious complications, such as joint infection, occur in fewer than 2% of patients. Major medical complications, such as heart attack or stroke, occur even less frequently. However, chronic illnesses may increase the potential for complications. Although uncommon, when these complications occur they can prolong or limit full recovery.
Blood clots in the leg veins or pelvis are the most common complication of hip replacement surgery. Your orthopaedic surgeon may prescribe one or more measures to prevent blood clots from forming in your leg veins or, if they do form, measures to prevent them from becoming symptomatic. These measures may include special support hose, inflatable leg coverings, ankle pump exercises, and blood thinners.
Leg-length inequality may occur or may become or seem worse after hip replacement. Your orthopedic surgeon will take this into account, in addition to other issues, including the stability and biomechanics of the hip. Some patients may feel more comfortable with a shoe lift after surgery.
Other complications such as dislocation, nerve and blood vessel injury, bleeding, fracture, and stiffness can occur. In a small number of patients, some pain can continue or new pain can occur after surgery.
Over years, the hip prosthesis may wear out or loosen. This problem will likely be less common with newer materials and techniques. When the prosthesis wears, bone loss may occur because of the small particles produced at the wearing surface. This process is called osteolysis.
Is Hip Replacement Surgery for You?
Although many patients who undergo hip replacement surgery are 60 to 80 years of age, orthopedic surgeons evaluate patients individually. Recommendations for surgery are based on the extent of your pain, disability, and general health status-not solely on age.
You may benefit from hip replacement surgery if:
- Hip pain limits your everyday activities such as walking or bending.
- Hip pain continues while resting, either day or night.
- Stiffness in a hip limits your ability to move or lift your leg.
- You have little pain relief from anti-inflammatory drugs or glucosamine sulfate.
- You have harmful or unpleasant side effects from your hip medications.
- Other treatments such as physical therapy or the use of a gait aid such as a cane do not relieve hip pain.