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Less Invasive (Minimally-Invasive) Surgery for Total Hip Replacement 

March 18th, 2021

Total hip replacement surgery has been performed in the US for over 50 years and has been one of the most successful procedures in the history of modern medicine. The number of hip replacements performed per year is edging closer to one million as better techniques and technology have made the surgery more reliable and less painful. It is an exciting time to be a hip replacement surgeon because of all of the latest developments. For the last 20 years, the focus at Rothman Orthopaedics has been to refine this procedure in order to provide a better experience for our patients. This includes less pain, faster return to activities, and longer lasting implants.   

Less invasive hip replacement surgery:
The philosophy of modern surgeons is to perform surgery with the least amount of disruption to surrounding structures and tissues. For years, our colleagues have performed abdominal surgery (laparoscopy) and sports medicine surgery (arthroscopy) through tiny incisions with thin telescopes smaller than a typical writing pen. However, successful “less invasive” surgery means much more than just operating through a smaller incision. The best patient results have been shown to occur with a combination of “rapid recovery” rehabilitation techniques (physical therapy), advanced pain control with medications and special injections, more experienced surgeons, and modern surgical approaches (where the incision is made and how tissues are preserved.)

Minimally invasive surgery:
This concept is based upon the theory that smaller incisions will lead to less scarring and pain resulting in faster recovery. Joint replacement surgeons have responded with techniques to perform surgery very accurately with smaller incisions. Rothman surgeons have been leaders in these techniques and have performed tens of thousands of these procedures. This is an area of great interest for our surgeons who teach this throughout the country. One of the problems facing joint replacement surgeons is actually that the standard techniques have been so successful it can be hard to show that changes can make a difference. Minimally invasive incisions are likely to remain a focus for our surgeons for many years.

Why all of the excitement about “surgical approaches”? 
This is a popular topic in newspapers, television as well as on the internet particularly the “Direct Anterior Approach.” The “approach” is basically where the surgeon makes the cut and how they expose the hip joint. Any approach anterior (front), lateral (side) and posterior (back) has a high level of success and the choice can vary depending upon the patient, the surgeon, and the type of implants that are going to be used. Surgeons at Rothman Orthopaedics have extensive experience with all of these techniques. Ask your surgeon which is the best option for your specific case.

Rapid recovery rehabilitation:
Many years ago joint replacement patients spent 3-4 weeks in a hospital; however, in recent years, the philosophy has completely changed. Our patients are not “sick.” They just have bad joints. Studies have shown that rapid mobilization of patients has many benefits including fewer complications, faster recovery and faster return to activity. The majority of our patients are on their feet a few hours after surgery and many go home the same day! Additionally, the surgeons at Rothman Orthopaedics have also been pioneers in helping you recover in the comfort of your own home using guided physical therapy on your smart phone or computer.

Advanced pain control:
For years patients have been afraid to have hip surgery because it was a painful procedure. Recent studies including those by Rothman Orthopaedics have shown that joint surgery does not have to be a very painful procedure! Our patients receive a combination of oral medications and advanced anesthesia techniques that minimize pain and is designed especially for them.


Advanced technology:
Whether it is robotics or computer assistance, technology has entered the world of surgery in a big way. Our surgeons have been involved from the beginning including design of these systems and their introduction to the US. Like the cell phone, it is unlikely that orthopaedic surgeons will give up their high-tech equipment. However, like the old “car phone,” these early designs are likely to be greatly improved over the years.  Your surgeon is the best resource to discuss whether technology is right for you!

Summary:
Joint replacement surgery is becoming more complex as technology and new techniques are being added every year. As one of the most advanced joint replacement centers in the world, Rothman Orthopaedics has experts in all of these innovations. Research shows that surgical experience is more important than any specific technique and that a combination of the above methods will have the best result.

Our surgeons perform thousands of these procedures per year and are excited to help you to make the best choices for your particular situation! For more information or to make an appointment with one of our joint replacement specialists, click here.

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