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Arthritis Health Center

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.
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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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