Total Hip Replacement Surgery
MAKOplasty Hip Replacement - (Robotic Assisted Surgery)
If you are considering hip surgery the following total hip replacement information might help you understand the procedure and implants better.
Your hips work hard during your daily routine, and arthritis of the hip or a hip injury can make it hard for you to perform normal tasks. If your injury or arthritis is severe, you may begin experience pain when you're sitting down or trying to sleep.
Sometimes a total hip replacement is the only option for reducing pain and restoring a normal activity level. If you and your doctor decide a total hip replacement is right for you, the following information will give you an understanding about what to expect.
A total hip replacement involves cutting away the damaged bone of the hip joint and replacing it with a prosthesis. This "new joint" prevents the bones from rubbing together and provides a smooth hip joint.
Traditional hip replacement surgery involves making a 10- to 12-inch incision on the side of the hip. The muscles are split or detached from the hip, allowing the hip to be dislocated.
Once the joint has been opened up and the joint surfaces exposed, the surgeon removes the ball at the top of the thighbone, or femur. The hip socket is prepared by removing any remaining cartilage and some of the surrounding bone. A cup-shaped implant is then pressed into the bone of the hip socket. It may be secured with screws. A smooth plastic bearing surface is then inserted into the implant so the joint can move freely.
Next, the femur is prepared. A metal stem is placed into the femur to a depth of about 6 inches. The stem implant is either fixed with bone cement or is implanted without cement. Cementless implants have a rough, porous surface. It allows bone to adhere to the implant to hold it in place. A metallic ball is then placed on the top of the stem. The ball-and-socket joint is recreated.
Minimally invasive hip replacement surgery allows the surgeon to perform the hip replacement through one or two smaller incisions.
Candidates for minimal incision procedures are typically thinner, younger, healthier, and more motivated to have a quick recovery compared with patients who undergo the traditional surgery.
Before you decide to have a minimally invasive hip replacement, get a thorough evaluation from your surgeon. Discuss with him the risks and benefits. Both traditional and minimally invasive hip replacement procedures are technically demanding. They require that the surgeon and operating team have considerable experience.
The artificial implants used for the minimally invasive hip replacement procedures are the same as those used for traditional hip replacement. Specially designed instruments are needed to prepare the socket and femur and to place the implants properly.
The surgical procedure is similar, but there is less soft-tissue dissection. A single minimally invasive hip incision may measure only 3 to 6 inches. It depends on the size of the patient and the difficulty of the procedure.
The incision is usually placed over the outside of the hip. The muscles and tendons are split or detached, but to a lesser extent than in the traditional hip replacement operation. They are routinely repaired after the surgeon places the implants. This encourages healing and helps prevent dislocation of the hip.
Two-incision hip replacement involves making a 2- to 3-inch incision over the groin for placement of the socket. A 1- to 2-inch incision is made over the buttock for placement of the stem.
To perform the two-incision procedure, the surgeon may need guidance from X-rays. It may take longer to perform this surgery than it does to perform traditional hip replacement surgery.
Reported benefits of less invasive hip replacement include:
- Less pain
- More cosmetic incisions
- Less muscle damage
- Rehabilitation is faster
- Hospital stays are shorter
For traditional hip replacement, hospital stays average 4 to 5 days. Many patients need extensive rehabilitation afterward. With less-invasive procedures, the hospital stay may be as short as 1 or 2 days. Some patients can go home the day of surgery.
Early studies suggest that minimally invasive hip replacement surgery streamlines the recovery process, but the risks and long-term benefits of less-invasive techniques have not yet been documented.
Research on the Horizon
Extensive study and development are now underway to determine the long-term benefits of minimally invasive hip replacement. New technology for imaging and computer-assisted implant placement has been developed.
Surgical technique continues to be modified as experience with minimally invasive hip surgery grows. This will allow more precise reconstruction of the hip with less direct visualization. In addition, new implant designs and materials are being developed to facilitate hip surgery and prolong the lifespan of replacements.