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Some patients with arthritis of the hip will have to undergo hip replacement. This article outlines the differences between the two types of hip replacement: traditional hip replacement and minimally invasive hip replacement.

Arthritis is an inflammatory condition characterized by joint stiffness and pain. There are more than a 100 individual subtypes of arthritis, with two of the most common ones being rheumatoid arthritis and osteoarthritis. While there is no cure the disease, there are several different treatment methods that can help relieve symptoms of arthritis and maintain joint functionality. Generally, patients are treated using a combination of medication and physical therapy. However, in extreme cases, doctors may recommend that patients undergo surgery.

When arthritis affects the hip joints, that causes significant pain in the hip. Hip pain can be especially debilitating because your hips bear so much of the body’s weight. Furthermore, being unable to move your hip joints can significant impair your quality of life. While doctors try to use conservative methods (such as medication) to help treat the pain, sometimes these methods don’t work.

Therefore, one of the most common surgeries that patients with arthritis undergo is a total hip replacement. For many people, a hip replacement surgery or arthroplasty can ease hip pain and allow patients to go back to conducting normal, everyday activities.

There are two different types of hip replacement surgeries — traditional hip replacement or minimally invasive hip replacement. For these two types of surgeries, the general procedure that takes place is the same. That is, the damaged portion of the hip is removed and replaced it with an implant. The hip is a ball-and-socket type joint. During hip replacement surgery, the top end of the thighbone (the ball) is replaced with a metal or a ceramic ball. The surface of the socket (the cartilage, a soft cushioning material) is replaced with a metal socket. Hence, this new ball and socket set works to restore smooth, pain-free functioning in patients with arthritis of the hip.

Traditional hip replacement

Hip replacement surgeries, while commonplace, require the orthopedic surgeon to have lot of skill and experience in order to ensure that the best outcome is available. While it is a highly complex surgery, it is one that has been well-established for decades and has been shown to help people gain pain-free movement and improve their ability to carry out everyday activities, and consequently, their quality of life.

During a traditional hip replacement, the surgeon will make a large incision on the side of the hip that is 10 to 12 inches long. This allows the whole joint to be exposed. Now, the surgeon will have access to the soft tissue that surrounds the joint. This will be separated to allow access and visibility of the hip joint. Then, the surgeon will conduct the procedure.

Due to the longer incision, and the significant disruption of muscles and other soft tissue, you will have to undergo a longer hospital stay and recovery period. Furthermore, you may experience more postoperative pain with the traditional surgery compared to the minimally invasive one.

Minimally invasive hip replacement

Minimally invasive hip replacement is a fairly new technique that follows the same basic procedure as the traditional hip surgery. Both of these types of surgeries require removing the damaged hip and inserting a prosthesis with the same type of implant. However, in the case of minimally invasive hip replacement, the surgeon makes a smaller incision which causes less disruption to the muscles and soft tissue in the region undergoing surgery. Special instruments are needed to perform a minimally invasive hip replacement and because of the reduced visibility of the joint, it is very important for the surgeon to be highly skilled in this procedure in order to reduce any complications.

Generally, the surgeon makes one or two small incisions during this type of surgery. In the single-incision procedure, the surgeon will make a three to six inch incision on the side of the hip which allows the surgeon to access the arthritic joint. In the double-incision procedure, one incision is about three inches and is made over the groin area while another is approximately two inches and is placed over the buttock area. The cuts are made close to the ball and socket areas of the hip.

Studies have shown that patients who undergo minimally invasive hip replacement compared to traditional hip replacement experience a faster recovery time and less pain. This type of surgery is mostly recommended for patients who are young and active.

Conclusion

Currently, there are several clinical trials and studies that are assessing the effectiveness and safety of using minimally invasive technique for total hip replacement over the standard technique. It will likely take years and several more studies before it can be definitely concluded that minimally invasive procedures are better than the traditional surgeries. Your orthopedic surgeon will recommend one or the other depending on a number of factors.

The surgeon and the patient will use all the knowledge available to make an informed choice on which type of surgery is better suited under the individual conditions. One of the reasons for one choice of surgery over another may just be the number of times that the surgeon has performed the surgery and feels comfortable doing it. It is important for you, as a patient, to be involved in the decision-making process.

  • Costa, Matthew L., et al. "Total hip arthroplasty versus resurfacing arthroplasty in the treatment of patients with arthritis of the hip joint: single centre, parallel group, assessor blinded, randomised controlled trial." bmj 344 (2012): e2147.
  • Lieberman, Jay R., et al. "Outcome after total hip arthroplasty: comparison of a traditional disease-specific and a quality-of-life measurement of outcome." The Journal of arthroplasty 12.6 (1997): 639-645.
  • Thomason III, H. Clayton, and Paul F. Lachiewicz. "The influence of technique on fixation of primary total hip arthroplasty in patients with rheumatoid arthritis." The Journal of arthroplasty 16.5 (2001): 628-634.
  • Photo courtesy of SteadyHealth

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