New Technique Revolutionizes Total Hip Replacement—
"MINI" hip replacement brings MAXIMUM benefit to patients
(New York, N.Y. May 1, 2003.) A major advance in the way total hip replacement surgery is performed means a much smaller incision, a quicker recovery and less pain for patients. In minimally invasive total hip replacement, highly specialized orthopedic surgeons use the standard implant, but insert it through a three or four inch incision as opposed to the usual 10 or 12 inches. Dr. Geoffrey Westrich, at the Hospital for Special Surgery, is among a limited number of highly specialized orthopedic surgeons doing "mini-incision" hip replacement, which achieves the same goal as the standard operation.
"Aside from the better cosmetic result, we have found that the smaller incision results in less pain for the patient, a quicker recovery, a shorter hospital stay and easier physical therapy after surgery," says Dr. Westrich. "This is a major advance in the way total hip replacement is performed."
Sixty-five year-old Eileen Leavell of Floral Park had severe arthritis in both hips. The pain was so bad, it woke her up at night. Almost two years ago, she had a standard hip replacement on her right side. Then, this past October, she had a "mini" on the other hip, ending up with an incision 10 inches shorter and a much faster recovery. "What a difference. The first time I had the operation, it was painful," she recalls. "After the second operation, I had very little pain and was up and around much quicker. It's really terrific." She says now her arthritis pain is gone, and she's getting back to activities she had abandoned.
Minimally invasive surgery in hip replacement is the latest take on a technique that has been used for years to remove the gallbladder or appendix, and even in certain types of heart surgery. In hip replacement, though, only a limited number of highly trained orthopedic surgeons with special expertise in hip anatomy have tackled the more challenging technique.
Sixty-six year-old Samuel Payne went in for total hip replacement after his athletic lifestyle, including 40 years of running, had taken a toll on his hip. "I had heard it was a painful operation, but after the surgery, it was amazing how it didn't hurt," said the New Jersey resident. The nurses who took care of him following the operation -- and his primary care doctor -- marveled at the size of the incision.
"I've been getting calls from the primary care doctors of my hip replacement patients asking me if I really did a full hip replacement, because the incision is so small. The doctors are completely taken by surprise," says Dr. Westrich, who has performed dozens of "minis."
The artificial hip joint, or prosthesis, that doctors use is the same in both the traditional and minimally invasive operation. Doctors do the "mini" using special retractors, which are used in surgery to hold open the skin and muscle after the incision is made. The new retractors allow the surgeon to see the hip even though the incision is very small. After removing the damaged cartilage and bone, the surgeon positions new metal and plastic joint surfaces to restore the alignment and function of the hip. Because the new surgical approach involves less trauma to muscles, patients recover more quickly.
Dr. Westrich, who performs about 75 percent of his hip replacement operations using the new technique, says the "mini" procedure may not be suitable for some patients because of their anatomy or weight. On the other hand, certain older patients who were apprehensive about a standard hip replacement and lengthy recovery may now be candidates for the new technique.