Over the last several years, the term “minimally invasive surgery” has been popularized. Many patients now request minimally invasive surgery. Over the last 20 years orthopaedic surgeons have recognized that hip and knee replacement surgery can be performed using less invasive incisions. This has the advantage of a potentially quicker recovery. In the orthopaedic literature (professional publications) recovery can occur sooner in the first 6 weeks, but after that little or no difference can be demonstrated between conventional surgery and minimally invasive surgery.
It has become clear that minimally invasive procedures can lead to significant complications, some potentially devastating to the patient. Joint replacement components require precise placement with respect to the bones and soft tissues. Recent reports have demonstrated that less optimal results can occur after minimally invasive procedures which require further surgery and prolonged recovery. It may be “penny wise and pound foolish” to jeopardize a good long term result for a temporary better result 4 weeks after surgery.
At the present time most experienced surgeons use the least extensive operation which is required to perform a high quality joint replacement operation.
Dr Incavo is happy to discuss the different types of surgical approach for hip and knee surgery and explain which is best for your individual situation.
MIS reduces TKA recovery time, but with more wound healing problems.
According to a study published in the journal Clinical Orthopaedics and Related Research, minimally invasive surgery (MIS) offers reduced recovery time when compared to conventional total knee arthroplasty (TKA), but is more likely to result in delayed wound healing and infection. The authors conducted a systematic review and meta-analysis of 13 studies (randomized controlled trials) published from 2007 to 2009 that compared MIS and standard TKA approaches. They found that mean Knee Society scores were better for patients in the MIS group at 6 and 12 weeks postoperative, but not after 6 months. They identified no differences between MIS and standard approaches regarding short-term complications and alignment of femoral and tibial components, but patients in the MIS group had longer operating times and more wound healing problems and infections.
Total Hip Replacement: Which approach is best for you?
These are several different surgical approaches and techniques for total hip replacement (THR). Each one offers unique benefits and is chosen depending on the situation. In general, there are 3 popular approaches: Direct anterior, Anterolateral, and Posterior.
There is no comparative study that provides convincing proof that one approach is superior to another and the best approach to use when performing THR remains controversial. The interest in recent years is focused on minimally invasive techniques and smaller incisions. However, the long term success of the implanted hip replacement avoiding complications is by far the most important aspect of the surgery.