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 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 provider 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 healthcare provider 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 and 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. A healthcare professional 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. He or she 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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