Minimally Invasive Total Hip Replacement

What is total hip replacement?

Total hip replacement is a type of surgery to replace a damaged hip joint. A minimally invasive total hip replacement uses a smaller cut (incision) than a traditional total hip replacement. It also uses special tools.

In the normal hip joint, the rounded head of the thighbone (the femoral head) moves smoothly inside the round socket of the hipbone. The socket normally has a lining of cartilage, which helps the bones move smoothly. When there is damage to this joint, moving the femoral head may cause pain as the bones scrape together abnormally.

During minimally invasive total hip replacement, your orthopedic surgeon makes an incision to access your hipbone and thighbone. Next, the surgeon removes the damaged femoral head and replaces it with a smooth, metal stem that attaches to the rest of the thighbone. Your surgeon also removes the damaged bone and cartilage within the socket of the hipbone, replacing it with a metal shell. Then the new femoral head can move inside the new, smooth socket of the hipbone.

Minimally invasive total hip replacement often takes place under spinal or general anesthesia.

Why might I need total hip replacement?

You might need a total hip replacement if you have significant damage to your hip joint. Different types of health conditions can damage this joint, such as:

  • Osteoarthritis (most common)
  • Rheumatoid arthritis
  • Osteonecrosis
  • Injury or break (fracture) of the hip joint
  • Bone tumor in the hip joint

This damage might be painful and interfere with your daily activities. The procedure may help decrease your pain, improve your joint mobility, and improve your quality of life. Usually, healthcare providers only recommend total hip replacement if you still have significant problems after you’ve tried other, more conservative treatments, like pain medicines and assistive walking devices.

Talk with your surgeon about the benefits and risks of having a minimally invasive total hip replacement instead of a traditional procedure. A minimally invasive procedure uses a smaller incision than a traditional hip replacement. This may lead to less pain and decreased recovery time. It's not yet clear if the procedure leads to a greater risk of certain complications.

In some cases, you may have other surgical options, like total hip resurfacing. Talk with your provider about the risks and benefits of all your options.

How do I get ready for total hip replacement?

Ask your provider how you should plan to get ready for your surgery.

Tell your provider about any medicines you are taking, including:

  • All prescription medicines
  • Over-the-counter medicines such as aspirin or ibuprofen
  • Illegal drugs
  • Herbs, vitamins, and other supplements

Ask if there are any medicines you should stop taking ahead of time, like blood thinners.

If you smoke, try to quit before your surgery.

If you are overweight, your provider may advise you to try to lose weight before your surgery.

Don’t eat or drink after midnight the night before your procedure.

You may want to make some changes to your house, to make your recovery smoother. This includes things like adding a handrail in your shower.

In some cases, your provider might want additional tests before you have your surgery. These might include:

  • X-rays, to get information about your hip
  • MRI, to get more detailed information about your hip
  • Electrocardiogram (ECG), to make sure your heart rhythm is normal

Follow any other instructions from your healthcare provider.

What happens during total hip replacement?

Your surgeon can help explain the details of your particular surgery. The details of your hip replacement surgery will depend on the nature of the injury and the surgical approach. An orthopedic surgeon assisted by a team of specialized healthcare professionals will do the surgery. The whole procedure may take a few hours. In general, you can expect the following:

  1. You will get general or spinal anesthesia so that you’ll sleep through the surgery and won’t feel any pain or discomfort during the procedure. (Or you may get local anesthesia and a medicine to relax you while keeping you awake.)
  2. An anesthesiologist will carefully watch your vital signs, like your heart rate and blood pressure, during the surgery.
  3. You may get antibiotics during and after the procedure to help prevent infection.
  4. Your surgeon will make an incision over the outside of your hip, cutting through your skin and muscle. Your surgeon may make 1 or 2 small incisions.
  5. Your surgeon will take your femoral head out of the hip joint socket. They will remove your femoral head and replace it with a metal or ceramic one.
  6. The damaged cartilage and bone that is lining the socket is removed.
  7. A metal cup is pushed into the socket and sometimes secured with screws.
  8. Your surgeon will place the femoral head into the new socket.
  9. The layers of skin and muscle of your incision will be closed.
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