Understanding Minimally Invasive Hip Replacement Techniques

Executive Summary

• Minimally invasive hip replacement uses smaller incisions and muscle-sparing methods to reduce tissue damage and improve surgical outcomes.
• Minimally invasive hip replacement can be performed through posterior, anterior, or lateral approaches and may employ advanced technology like robotic-assisted systems and imaging to increase implant precision.
• When compared to traditional methods, minimally invasive hip replacement can result in smaller scars, less blood loss, lower infection risk, shorter hospital stays, faster recovery, and minimized pain.
• Most minimally invasive hip replacement patients can go home shortly after surgery, walk with assistance within the first week, function independently within 2-6 weeks, and resume low-impact activities in 3 months.

A Modern Approach to Hip Replacement

Hip replacement surgeries have been performed for well over a hundred years. Ever since German Professor Themistocles Glück made the first recorded attempt back in 1891, the process has evolved and become much more efficient. 

Initially, surgeons had to use an open approach that required them to make a large incision. During this process, the surgeon had to cut through several muscle layers and dislocate the hip joint to replace the damaged components. Although this method was effective, it often resulted in long recovery times, substantial post-operative pain, and large scars.

Nowadays, minimally invasive hip replacement gives countless patients lasting relief from their chronic joint pain caused by arthritis, injury, or other degenerative conditions. This approach only requires one or two relatively minor cuts and muscle-sparing techniques, reducing trauma to surrounding tissues and helping patients recover more quickly.

In addition to explaining the basics of this procedure, the comprehensive guide below explores minimally invasive hip replacement pros and cons, expectations for minimally invasive hip replacement recovery times, and how those aspects stack up against traditional surgery.

What Is Minimally Invasive Hip Replacement?

Minimally invasive hip replacement is a surgical technique that replaces the damaged hip joint with as few incisions as possible. By creating only one or two 3 to 6-inch incisions, surgeons are able to minimize disruption to surrounding muscles and soft tissue. On the other hand, traditional methods typically require an 8- to 12-inch incision and slicing through major muscle groups.

The main difference separating minimally invasive hip replacement vs traditional is the former’s focus on muscle-sparing approaches. Instead of detaching large sections of muscle, the surgeon works between muscle fibers to preserve as much of the patient’s strength and stability as possible. As a result, minimally invasive approaches have been able to shorten the hip replacement surgery recovery timeline drastically.

Common Types of Minimally Invasive Techniques

Some situations allow surgeons to take a single-incision approach to minimally invasive hip replacement surgery. In this scenario, the surgeon only has to make one small incision, usually on the side or front of the hip, and they work solely through this entry point to replace the joint.

However, sometimes surgeons need to use a two-incision technique, where one small incision is made at the front of the hip to insert the socket portion of the implant, and another incision is made in the back to accommodate the femoral stem.

The main goal of both technique types is the same: to reduce trauma, which can minimize swelling after a hip replacement, help the patient maintain muscle integrity, and expedite their overall recovery.

Benefits of Minimally Invasive Techniques

Patients considering hip surgery often ask about the pros and cons of minimally invasive hip replacement. While each case is different, many studies and patient reports highlight several potential benefits of surgeons taking a minimally invasive approach, including:

• Reduced scarring from smaller incisions
• Less blood loss, which lowers the risk of needing a transfusion
• Lower infection risk thanks to the reduced exposure of internal tissues
• Shorter hospital stays, allowing many patients to go home the same day
• Faster recovery and potential to walk without assistance shortly after surgery
• Reduced pain due to less tissue trauma, decreasing the need for opioids

Who Is a Good Candidate?

Before recommending minimally invasive hip replacement, surgeons are expected to carefully consider a wide range of factors to ensure the patient is a good fit. Some examples of viability-related factors that can vary between patients are:

• Age and overall health – Generally, the younger, healthier, and more active an individual is, the more equipped their body is to handle a hip replacement surgery.
• Weight/BMI – Having a lower BMI can facilitate your surgeon’s ability to work through smaller incisions.
• Bone quality and joint structure – Conditions like osteoporosis may require more traditional approaches to hip replacement due to the severe degradation of the joint structure.
• Lifestyle goals – Athletes and active adults are often interested in recovering as fast as possible so they can return to their routines, causing them to seek minimally invasive joint replacement surgery.

Ultimately, your surgeon will decide if minimally invasive techniques are suitable for you by conducting a thorough evaluation and considering your imaging, medical history, and functional needs. Thanks to these assessments, medical professionals can select the safest and most effective approach for you.

Key Surgical Techniques Explained

The term “minimally invasive” only describes the incision size and tissue-sparing approach, not where the incision is made, meaning the approach to accessing the hip can vary across minimally invasive hip replacement surgeries. The following three approaches are the most commonly used techniques for this type of surgery.

Posterior Approach 

This method involves making the minimally invasive incision(s) in the back of the hip. This method is popular amongst surgeons because it provides excellent visibility of the joint and allows for precise implant placement. Nevertheless, surgeons must focus on carefully working between the various posterior muscles rather than cutting through them. 

Direct Anterior Approach

Differing from the posterior approach, an anterior total hip replacement involves gaining access through the front of the hip. It is a great way to avoid major muscle cutting, allowing near-immediate weight-bearing after surgery for many patients. Still, it requires specialized training and advanced equipment to complete in an effective and minimally invasive way. 

Lateral Approach

Sometimes, surgeons avoid the two approaches above and decide to make an incision on the side of the hip. This lateral approach requires sparing specific muscles, but it can give surgeons a balanced view of the joint.

For all three approaches above, surgeons may use robotic-assisted platforms like the CORI surgical system or Mako SmartRobotics™, along with fluoroscopic imaging, to improve accuracy in implant positioning, which is critical for joint longevity and function.

Recovery and Rehabilitation

One of the most common questions medical providers get from patients considering a hip surgery is “How long is the recovery time for minimally invasive hip replacement?” Reading through the following considerations can help you make informed decisions about whether to get a minimally invasive hip replacement vs traditional.

Typical Recovery Timeline

Although each patient is unique, most minimally invasive hip replacement recovery timelines can be broken up into four stages, including:

• Hospital stay – Many patients are able to leave within 24 hours of their surgery, compared to the 2 to 4 day average of a traditional surgery.
• First week – Walking with a cane or walker is common in the first week. Still, pain is generally less intense than what is experienced during larger-incision surgeries.
• Weeks 2 through 6 – At this stage, most patients regain independence in their daily activities. However, swelling and stiffness may still be in the process of decreasing.
• Three months and beyond – After a few months, most patients can return to low-impact activities like cycling, swimming, or golf.

How It Compares to Traditional Surgery

Generally, traditional hip replacement requires a longer initial recovery with more post-operative pain, and many patients need assistive devices for several weeks. With that being said, long-term results, when it comes to function and implant lifespan, may be similar for both minimally invasive and traditional methods, as long as experienced surgeons perform them.

Tips for a Smoother At-Home Recovery

Some examples of valuable home recovery tips to follow after your surgery are:

• Ensure your home has stable furniture, handrails, and clear walking paths
• Closely follow your physical therapy plan for strength and mobility restoration
• Periodically, ice and elevate your legs to control swelling
• Closely monitor your incision for signs of infection
• Stay active with gentle movement, but avoid twisting or high-impact sports

In addition to the tips above, nutrition is imperative to the recovery from joint replacement surgery. Therefore, you should eat a balanced diet and prioritize hydration.

Helping Patients Recover Faster

When deciding between minimally invasive hip replacement vs traditional approaches, it is important to remember that the former can reduce surgical trauma, which can help patients recover faster and with less pain. Assuming you are a suitable candidate, the shortness of minimally invasive hip replacement recovery times can help you get back to the activities you love faster.

The Joint Replacement Center of Scottsdale specializes in both minimally invasive knee surgery and hip replacements. We combine our minimally invasive approaches with advanced imaging, careful pre-surgical planning, and rehabilitation that is tailored to each patient, making a life-changing difference for many eligible patients.

If you’re wondering whether a minimally invasive hip replacement is right for you, schedule an initial consultation with the orthopedic team at the Joint Replacement Center of Scottsdale. With a personalized evaluation, we can get you on the right track toward a safer, faster, and more comfortable recovery.