Minimally Invasive Knee Replacement
The traditional approach to knee replacement uses a long vertical incision in the center of the knee to view and access the joint. Minimally invasive total knee replacement is a variation of this approach.
Unlike traditional total knee replacement, the minimally invasive technique is not suitable for all patients. Dr. Dolan will discuss the different surgical options with you.
The Procedure
In minimally invasive knee replacement, the procedure is similar, but a smaller incision is made and there is less cutting of the tissue surrounding the knee. The artificial implants used are the same as those used for traditional knee replacement. Because the techniques used to expose the joint involve less disruption to the muscle, it may lead to less postoperative pain and reduced recovery time.
After The Procedure
Physical rehabilitation is a critical component of recovery. Your surgeon or physical therapist will provide you with specific exercises to help increase your range of motion and restore your strength.
Minimally Invasive Anterior Hip Replacement
There are a variety of different surgical approaches through which a hip replacement can be performed. The direct anterior approach is a minimally invasive surgical technique that does not detach any muscles from your hip or pelvis. This is a muscle sparing approach that goes through the front part of your thigh and hip joint to place the artificial joint.
Not all patients are candidates for direct anterior hip replacement, with the major restrictions being body weight (body mass index greater than 35) and complex hip disorders (e.g. hip dysplasia, previous surgeries, etc.). Dr. Dolan will discuss the different surgical options with you.
The Procedure
This approach involves a 4-6 inch incision on the front of the hip that allows the joint to be replaced by moving muscles aside along their natural tissue planes, without detaching any tendons. During hip replacement, Dr. Dolan will remove the damaged sections of your hip joint and replace them with parts usually constructed of metal, ceramic, and very hard plastic. This artificial joint (prosthesis) helps reduce pain and improve function.
After The Procedure
Hip replacement, no matter how minimally invasive, is major surgery and requires time to recover. With the anterior approach, there are typically fewer post-operative restrictions and the possibility of a faster healing time. Depending on your overall health and activity level, you will either have a brief hospital stay or be able to go home on the day of surgery. Most patients require the use of a walking aid (walker or crutches) for about 2-3 weeks. By 6 weeks out from surgery, most patients are walking 1-1.5 miles a day with minimal pain and no limp. Most people resume their normal activities by this time — even if in a limited fashion. Further recovery with improving strength will often occur for six to 12 months.
Expect your new hip joint to reduce the pain you felt before your surgery and increase the range of motion in your joint. But don't expect to do everything you couldn't do before surgery. High-impact activities — such as running or playing basketball — may be too stressful on your artificial joint. But in time, you may be able to swim, play golf, hike or ride a bike comfortably.
Minimally Invasive Posterior Hip Replacement
There are a variety of different surgical approaches through which a hip replacement can be performed. The minimally invasive posterior approach is the most popular surgical approach in the United States for hip replacement surgery and provides excellent results, and remains the standard to which other surgical approaches are commonly compared..
The Procedure
This incision for this approach is on the side part of your hip and typically is 4-6 inches long. The external rotator muscles on the back of your hip are detached with this surgical approach, but are repaired at the end of surgery. During hip replacement, Dr. Dolan will remove the damaged sections of your hip joint and replace them with parts usually constructed of metal, ceramic, and very hard plastic. This artificial joint (prosthesis) helps reduce pain and improve function.
After The Procedure
Hip replacement, no matter how minimally invasive, is major surgery and requires time to recover. With the posterior approach, patients must follow certain hip precautions for 1 month following surgery. Depending on your overall health and activity level, you will either have a brief hospital stay or be able to go home on the day of surgery. Most patients require the use of a walking aid (walker or crutches) for about 2-3 weeks. By 6 weeks out from surgery, most patients are walking 1-1.5 miles a day with minimal pain and no limp. Most people resume their normal activities by this time — even if in a limited fashion. Further recovery with improving strength will often occur for six to 12 months.
Expect your new hip joint to reduce the pain you felt before your surgery and increase the range of motion in your joint. But don't expect to do everything you couldn't do before surgery. High-impact activities — such as running or playing basketball — may be too stressful on your artificial joint. But in time, you may be able to swim, play golf, hike or ride a bike comfortably.
Anterior vs. Posterior Hip Replacemet Surgery
Dr. Dolan would be happy to discuss with you which surgery is best for you and the reasoning behind this decision. Despite many sources touting the benefit of one hip replacement approach over the other, both the anterior and posterior approaches provide great results for patients. It is important to keep in mind that hip replacement surgery (no matter the approach) is one of the most successful procedures in all of medicine. Listed below are some perceived benefits of each approach.
Benefits of posterior approach:
- Incision is hidden on the side of hip out of view.
- Incision heals very well no matter the body habits of patients.
- Fast recovery because the most important hip muscles are not detached or disturbed.
Benefits of anterior approach:
- No detachment of any muscles allowing for a fast recovery.
- Decreased risk of dislocation.
- Use of X-ray at the time of surgery to help with component position.
Downsides of posterior approach:
- Must follow posterior hip precautions.
- Risk of dislocation posteriorly (<1% in Dr. Dolan’s practice).
Downsides of anterior approach:
- Must follow anterior hip precautions (however these are less cumbersome than posterior hip precautions).
- Risk of dislocation anteriorly (<1% in Dr. Dolan’s practice).
- Wound healing problems – the skin on the front part of the hip is thin.