Put the Swing Back in Your Step

Less is More With Minimally Invasive Hip Surgery

By Mark W. Woolf, M.D.

 

Osteoarthritis of the hip is a painful condition. Most people with hip arthritis have difficulty walking, climbing stairs, and performing routine daily activities. They often feel pain in the groin, thigh, and buttocks and have referred pain in the knee causing many to walk with limps.

 

The condition can develop as the result of an injury or other developmental abnormalities of the hip, but most people develop arthritis as a result of lifelong wear and tear.

 

Physical therapy and gentle, supervised yoga are often useful, bringing stability and lubrication to the hip joint as well as stretching and strengthening surrounding muscles, which tend to tighten with joint instability. Women, in particular, tend to walk with the tailbone tilted backward, which keeps the lower back arched. Anti-inflammatory medications and nutritional supplements such as glucosamine may also provide some relief, while weight loss can decrease stress on all of the joints.

 

Treating Osteoarthritis of the Hip

 

Physicians may recommend hip-replacement surgery. Osteoarthritis of the hip is the most common diagnosis that leads to hip replacement, and here, too, there is more than one alternative, including minimal incision hip replacement surgery.

 

Conventional hip replacement involves making a 10-inch to 12-inch incision in order to reach and repair the hip. Minimally invasive surgery is performed through one or two smaller incisions.

 

A single, minimally invasive hip incision may measure only 3 inches to 6 inches, depending on the size of the patient and the difficulty of the procedure. This incision is usually placed over the outside of the thigh.

 

Muscles and tendons are split or detached to a lesser extent than in the traditional hip replacement operation, and these are routinely repaired after placing the implants to help healing and prevent hip dislocation.

 

Two-incision hip replacement, meanwhile, involves making a 3-inch to 4-inch incision over the groin for placement of the socket and a 3-inch to 4-inch incision over the buttock for placement of the stem.  The two-incision procedure usually adds 30 to 45 minutes of surgical time compared to traditional hip-replacement surgery.

 

“Low-Wear” Hip Replacements

 

Minimally invasive knee replacement can mean smaller scars and a quicker recovery than traditional total hip replacement.  “Low-wear" hip replacements use all metal bearing surfaces that show low  wear rates after more than 30 million steps — or the equivalent of approximately 30 years of use.