What is minimally invasive hip surgery?
Lately there have been improvements in the results of hip prostheses, thanks to materials such as polyethylene, and advances in the treatment of soft tissue at the time of implanting the prosthesis. New techniques have been appearing such as: Superior Direct, Super PATH, anterior approach, MIS posterior.
Each one has advantages and disadvantages such as heterotopic calcifications or residual lameness, among others. The first disadvantage of minimally invasive surgery is that it is more difficult to place and implant the prosthesis with a correct position, since the surgical field is smaller.
This operation consists of placing the total hip prosthesis through small incisions without the need to section anatomical structures such as tendons, fascia or joint capsule. In this way, functional recovery is faster and with fewer sequelae.
What is the difference with conventional surgery?
The prostheses used are the same as usual, the only change is in the type of incision and the treatment of soft parts to reach the bone. The incisions are 8 – 10 cm and require a longer surgery time (20 minutes more).
What are the advantages over other more conventional techniques?
As it is less invasive, recovery will be faster, getting to walk the same day of the operation. It also reduces complications, bleeding, pain, dislocations.
In what cases can this technique be used?
In general, it can be performed in most cases. It is not recommended in hip prosthesis replacements where conventional incisions are made to expose and remove the mobilized prosthesis. In addition, it is also more difficult in cases of hip dysplasia, deep coxae or hip ankylosis.
A previous examination of the patient is essential, as well as a preoperative planning of the case and the components. It is more difficult to perform it in obese patients or those with a lot of muscle due to the limited vision of the surgical field.
Despite the disadvantages, it is worthwhile to perform this surgery due to the prompt recovery of the patients, the average stay of 48 hours in the hospital and the minimal frequency of residual lameness.