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Minimally-Invasive Joint Replacement:
Is It Right for You?
When the pain of a bad hip or knee joint becomes too much, many people look into joint replacement to find relief. Over the last 40 years, joint replacement surgery has undergone a dramatic transformation, including improved joint components to the latest technique of minimally invasive joint surgery (MIS).
In recent years, minimally invasive surgery has become the generally regarded state-of-the-art approach to joint replacement. However it’s not right for everyone. Many people who hear about the new technique for joint replacement are excited because of the smaller incision, but fail to recognize the other factors that make minimally invasive surgery possible.
“Often people ask about the minimally invasive surgery, but they may not be good candidates,” said Stephen Smith, M.D., orthopedic surgeon with Physicians Clinic Norfolk Medical Group. “I’ve always strived to give the patient the best aesthetic result possible. For years I’ve been doing my procedures with smaller incisions to achieve the best outcome for my patients.”
Is it Right for You?
The ideal candidates for this type of surgery are thinner, in good body condition, have muscle tone and have never had joint replacement surgery at that site. Being in good health also helps in the rehabilitation process.
Obesity and joint revisions are two of the reasons many people are not good candidates for the procedure. Overweight patients have more body mass and tissue to work around. A smaller incision limits the physician’s visual of the joint and surrounding tissues. There may be underlying damage that can’t be seen with a small incision. Another risk of a small incision on a larger person is the potential to stretch the ligaments beyond repair.
When Less is More
The less invasive technique allows Dr. Smith to replace the joint with a significantly smaller incision. A traditional incision in the case of a hip replacement would be reduced from 9 inches down to 3 or 4 inches, and knee replacement from 12 inches down to 4 or 5 inches long.
The benefit of the smaller incision is more than just cosmetic. There is also the reduced risk for blood loss, less damage to the soft tissue, infection and a quicker recovery after surgery. A smaller incision also makes it possible to perform the MIS with available epidural anesthesia and light sedation, avoiding some of the complications of general anesthesia.
Realistic Expectations
“My goal is to have an appropriate sized incision for each patient. For some it may be a 3 inch incision, others it may be 4 or 5 inches,” added Dr. Smith. “I don’t want to compromise the integrity of the joint for outward appearances only.”
Even though the procedure is called minimally invasive, because of the smaller incision and reduced trauma to the soft tissues it can be somewhat misleading. The procedure reduces the need to cut the muscle, but joint replacement still involves cutting of bone, realigning the soft tissue that supports the joint and placing the implant, which is performed through a significantly smaller incision site. There may be discomfort due to the manipulation of the tissues, but generally the patient experiences less pain.
“It’s been my experience that patients who’ve had the minimally invasive surgery are able to initiate rehabilitation sooner and experience less pain,” said Dr. Smith. “Several factors influence their rapid recovery: less pain, smaller incision, overall health and motivation.”
Many orthopedic surgeons review each patient’s case and the decision on whether minimally invasive surgery is appropriate is made after weighing many factors, including the surgeon’s advice, as well as patient input. The goal is the same for the hospital, physician and patient: to get the patient functioning independently and without pain.
The Surgery Department at Faith Regional Health Services works closely with orthopedic surgeons to provide state-of the art facilities and instrumentation to ensure successful joint replacements.
Last Updated: 7/24/2006
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