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 incision than a traditional total hip replacement and involves the use of special instruments.

In the hip joint, the rounded head of the thigh bone (the femoral head) moves smoothly inside the round socket of the hip bone. 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 hip bone and thigh bone. Next, the surgeon removes the damaged femoral head and replaces it with a smooth metal stem that attaches to the rest of the thigh bone. Your surgeon also removes the damaged bone and cartilage within the socket of the hip bone, replacing it with a metal shell. Then the new femoral head can move inside the new smooth socket of the hip bone.

Minimally invasive total hip replacement often takes place under spinal or general anesthesia. Your surgeon will make an incision to access your hip joint, replacing the femoral head and the socket of the hip bone.

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 medical conditions can damage this joint, like:

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

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

Talk with your doctor about the benefits and risks of having minimally invasive total hip replacement instead of traditional total hip replacement. Minimally invasive total hip replacement uses a smaller incision than a traditional hip replacement, so it may lead to less pain and decreased recovery time. It is not yet clear whether the procedure leads to increased risk of certain complications, though.

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

What are the risks of total hip replacement?

Most people do very well with their minimally invasive total hip replacement. However, as with any surgery, the procedure does carry some relatively rare risks. Possible complications of the surgery include:

  • Infection
  • Excess bleeding
  • Blood clots
  • Injury to nearby nerves
  • Dislocation of the hip joint
  • Having one leg that is a little shorter than the other
  • Loosening of the hip joint

There is also a slight risk that the procedure might not get rid of your pain, or that it might leave you with new pain. Your own risk of complications may vary according to your age and your other medical conditions. Ask your doctor about the risks that most apply to you.

How do I get ready for total hip replacement?

Ask your doctor how you should plan to prepare for your surgery. Ask if there are any medications you should stop taking ahead of time, like blood thinners. If you are a smoker, you should try to quit before your surgery. If you are overweight, your doctor may advise you to try to lose weight before your surgery. You may also want to make some changes to your house, like adding a handrail in your shower, to make your recovery smoother.

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

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

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

What happens during total hip replacement?

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

  • You will receive general or spinal anesthesia so that you’ll sleep through the operation and won’t feel any pain or discomfort during the procedure. (Or you may receive local anesthesia and a medication to relax you while keeping you awake.)
  • A healthcare professional will carefully monitor your vital signs, like your heart rate and blood pressure, during the operation.
  • You may receive antibiotics, during and after the procedure, to help prevent infection.
  • Your surgeon will make an incision over the outside of your hip, cutting through your skin and muscle. Your doctor may make one or two small incisions.
  • 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 one.
  • The damaged cartilage and bone that is lining the socket is removed.
  • A metal cup is pushed into the socket and secured with screws.
  • Your surgeon will place the femoral head into the new socket.
  • The layers of skin and muscle of your incision will be closed.

What happens after total hip replacement?

Talk with your doctor about what you can expect after your surgery. You may have some pain around your incision after your procedure, but you can take medications to relieve your pain. You should be able to resume a normal diet fairly quickly.

You may have imaging, like an X-ray, to see how your surgery went. You might be able to go home within a day or two.

Your doctor will let you know when you can put weight on your leg. You may have specific instructions about limiting your movements. You might need to use a cane, a walker, or crutches for a few days or weeks. A physical therapist can help you maintain your range of motion and strength. You should be able to resume most light activities within a couple of weeks. During this time, you may find it helpful to have some extra help at home.

You might have some fluid draining from your incision. This is normal during the first few days after surgery. Let your doctor know right away if you have increased redness, swelling, or draining from your incision, high fever, or severe pain. Also, let your doctor know if your pain is not improving. Most people notice a dramatic improvement in their pain after their surgery.

Make sure to keep all of your follow-up appointments with your orthopedic surgeon, and follow all your doctor’s instructions. You may need to have your stitches removed a week or so after your surgery.

The mechanical components of your hip may wear out or loosen over time. Because of this, you may need a revision surgery 10 to 20 years after your original minimally invasive total hip replacement. You may be able to extend the life of your implant by exercising regularly and taking precautions to avoid falls.

Next steps

Before you agree to the test or the procedure make sure you know:

  • The name of the test or procedure
  • The reason you are having the test or procedure
  • The risks and benefits of the test or procedure
  • When and where you are to have the test or procedure and who will do it
  • When and how will you get the results
  • How much will you have to pay for the test or procedure