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    Is Less-Invasive Hip Replacement Best for You?

    Finding the right surgeon and asking the right questions can help determine if minimally invasive hip replacement is right for you.

    The Reality of Complications continued...

    How many operations have you done with your current techniques?

    • Each technique has its own learning curve. For the mini-incision technique, "it is short, probably about 10 cases," suggests Allan E. Gross, MD, professor and chairman of orthopaedic surgery at the University of Toronto.
    • For the two-incision technique, however, surgeons should do a minimum of 50 two-incision operations per year, suggests Gross.
    • "Patients should recognize that if they're going to use a minimally invasive method, they need to be skeptical about whether or not that procedure can be done at the present time by most surgeons with as low a complication rate and as high a durability as conventional methods," suggests the Mayo Clinic's Berry.
    • "Is it hard? Of course it's hard. Should you go to someone with experience and training? Of course," says innovator Berger.

    Are the short-term results of minimally invasive hip replacement any better than those for standard incisions?

    • Two provocative clinical trials presented at the AAOS meeting suggest the mini-incision technique offers little more than a shorter scar. One trial from Belfast, Northern Ireland, compared more than 200 patients. The other trial, led by Jefferson's Rothman, involved 120 patients.
    • Though the short- and long-incision operations were equally safe, none of the hoped-for advantages of the mini-incision technique materialized in either trial. "The size of the incision doesn't matter," Graham Bailie, MD, a co-researcher of the Irish trial, told WebMD.
    • As for the two-incision technique, researchers haven't yet presented head-to-head trials comparing it with a mini-incision or standard technique.

    Are some patients especially poor candidates for a minimally invasive hip replacement?

    • Though there is disagreement, most experts say it is not the right operation for patients who have excessively fleshy or very muscular thighs and buttocks, severe hip deformities, or a previous hip replacement.

    Can you provide me with the names of five or six of your patients I can talk to about this?

    • Talking to others who have been through minimally invasive hip replacement may help you decide how to proceed.

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