1. Minimally Invasive Hip Surgery

2. Introduction Many people suffering from arthritis alter their lives to deal with pain. Many people suffering from arthritis alter their lives to deal with pain. If you haven’t found relief in medicines, exercises, and weight- management, hip replacement surgery may be a solution. If you haven’t found relief in medicines, exercises, and weight- management, hip replacement surgery may be a solution.

3. Background on Minimally Invasive Surgery A significant advancement in total hip replacement A significant advancement in total hip replacement MIS is not new MIS is not new Performed on knees Performed on knees Cardiac patients Cardiac patients

4. What is Minimally Invasive Hip Surgery? New surgical technique. New surgical technique. Uses traditional hip implant components. Uses traditional hip implant components. Different techniques, including mini- incision and two-incision. Different techniques, including mini- incision and two-incision.

5. Difference Between Traditional and Minimally Invasive Hip Replacement Surgery Traditional Hip Replacement Surgery Traditional Hip Replacement Surgery Proven in clinical studies and successfully performed for decades Proven in clinical studies and successfully performed for decades Allows surgeon full visualization of operative area Allows surgeon full visualization of operative area Larger incision (12-18 inches) Larger incision (12-18 inches) More disruption of muscles and tissues More disruption of muscles and tissues Minimally Invasive Hip Replacement Surgery Long-term effects and success are being studied Smaller incisions (2-4 inches) Potentially less disruption of muscles and tissues May lead to less blood loss Potential for less postoperative pain

6. Difference Between Traditional and Minimally Invasive Hip Replacement Surgery Traditional Hip Replacement Surgery Traditional Hip Replacement Surgery Average hospital stay is five days Average hospital stay is five days Average recovery time of approxmiately 3 months (individuals will vary) Average recovery time of approxmiately 3 months (individuals will vary) Leaves a larger scar on patient’s thigh Leaves a larger scar on patient’s thigh Minimally Invasive Hip Replacement Surgery May lead to a shortened hospital stay May reduce recovery time Scars will be smaller and less noticeable

7. Minimally Invasive Hip Surgery Same implants as traditional hip replacement surgery. Same implants as traditional hip replacement surgery. Components Components Cup Cup Ball Ball Stem Stem Cup Ball Stem

8. Ideal Candidate for Minimally Invasive Hip Surgery Suffering from hip arthritis and failed to respond: Suffering from hip arthritis and failed to respond: Medicines Medicines Exercise Exercise Weight-management programs Weight-management programs Deciding factors include: Deciding factors include: Medical history Medical history Weight Weight General health General health Body structure, including bone structure Body structure, including bone structure Extent and pattern of arthritis Extent and pattern of arthritis

9. Inappropriate Candidates for Minimally Invasive Hip Surgery Severely obese Severely obese Very muscular Very muscular Undergoing complex revision surgeries Undergoing complex revision surgeries

10. Different Techniques Used for Minimally Invasive Hip Surgery Two-Incision 2 incisions 2 incisions Approximately 2 inches in length Approximately 2 inches in length On both front and rear of thigh On both front and rear of thigh Mini-Incision 1 incision Approximately 3 to 4 inches in length Either front or rear of thigh

11. Different Techniques Used for Minimally Invasive Hip Surgery Two-Incision Estimated 80 mins. To 2 hours Estimated 80 mins. To 2 hours Fluoroscopy may be used. Fluoroscopy may be used. Mini-Incision Patients lay on their side. Fluoroscopy is not used.

12. Surgical Procedure Incision is made. Incision is made. Socket re-shaped to fit new cup implant; replaces the diseased socket. Socket re-shaped to fit new cup implant; replaces the diseased socket. New cup placed in socket. New cup placed in socket. Source: www.Allaboutarthritis.com, 2003www.Allaboutarthritis.com

13. Surgical Procedure, continued Femur prepared for the stem. Femur prepared for the stem. Hip stem implanted. Hip stem implanted. Ball put in place on top of stem. Ball put in place on top of stem. Incision is closed. Incision is closed. Source: www.Allaboutarthritis.com, 2003www.Allaboutarthritis.com

14. Benefits of Minimally Invasive Hip Surgery Less trauma to the body. Less trauma to the body. Healing and rehabilitation potentially quicker. Healing and rehabilitation potentially quicker. Hospital stays can be shorter. Hospital stays can be shorter. Allows for immediate stability of the hip. Allows for immediate stability of the hip. Lower risk of dislocation. Lower risk of dislocation. Potentially less postoperative pain. Potentially less postoperative pain. Cosmetically appealing. Cosmetically appealing.

15. Preparing for Minimally Invasive Hip Surgery Strength conditioning enhances recovery. Strength conditioning enhances recovery. Strengthen upper body and opposite leg in preparation for using crutches. Strengthen upper body and opposite leg in preparation for using crutches. Visit a physical therapist to: Visit a physical therapist to: Know what to expect in the hospital Know what to expect in the hospital Learn how to protect the hip after surgery Learn how to protect the hip after surgery Get answers to questions about rehabilitation Get answers to questions about rehabilitation Get additional information from www.jointreplacement.com in the physical therapy section. Get additional information from www.jointreplacement.com in the physical therapy section. www.jointreplacement.com

16. Before Surgery Medical evaluation will be completed. Medical evaluation will be completed. Alleviate anxiety Alleviate anxiety Learning more about what to expect Learning more about what to expect Sources: Sources: Patient brochures and videos (distributed by doctor) Patient brochures and videos (distributed by doctor) Internet education (www.jointreplacement.com) Internet education (www.jointreplacement.com)www.jointreplacement.com Discussion with doctor Discussion with doctor

17. Physical Therapist Role The physical therapist will visit the day or day after surgery. The physical therapist will visit the day or day after surgery. Physical therapist will assess: Physical therapist will assess: Range of motion. Range of motion. Ability to move in bed. Ability to move in bed. Breathing. Breathing. Ability to bear weight. Ability to bear weight. Will help with everyday activity evaluation/instruction. Will help with everyday activity evaluation/instruction. Using the toilet. Using the toilet. Bathing. Bathing. Getting in and out of a chair. Getting in and out of a chair.

18. Hospital Discharge General Guidelines Accomplish the following activities before leaving the hospital: Accomplish the following activities before leaving the hospital: Walking 100 feet with assistive device. Walking 100 feet with assistive device. Learn to climb stairs safely. Learn to climb stairs safely. Exercising independently. Exercising independently. Equipped with assistive devices such as a sock tool, wedge pillow and a raised toilet seat. Equipped with assistive devices such as a sock tool, wedge pillow and a raised toilet seat.

19. Recovery After Surgery The healing hip has a limited range of safe motion. The healing hip has a limited range of safe motion. Follow safety rules, such as: Follow safety rules, such as: Not crossing your legs. Not crossing your legs. Take care when bending. Take care when bending. Avoid high-impact and contact sports. Avoid high-impact and contact sports. Follow doctor’s instructions for a complete recovery. Follow doctor’s instructions for a complete recovery.

20. Potential Complications and Risks Factors that may affect the rate of complications including. Factors that may affect the rate of complications including. The skill of the surgeon. The skill of the surgeon. Weight, age and overall health of the patient. Weight, age and overall health of the patient. The lifestyle and activities of the patient. The lifestyle and activities of the patient. Presence of osteoporosis or other conditions that weaken bones. Presence of osteoporosis or other conditions that weaken bones. Patient compliance with instructions. Patient compliance with instructions.

21. Potential Complications and Risks, continued Hematoma Hematoma Occurs when blood enters the wound after surgery. Occurs when blood enters the wound after surgery. If excessive, will be drained. If excessive, will be drained. Fracture Fracture From weak bones. From weak bones. Patient falls. Patient falls. Not following precautions. Not following precautions.

22. Potential Complications and Risks Infection Infection Dislocation Dislocation Blood clots Blood clots

23. The Future of Minimally Invasive Hip Surgery Evolving Evolving Clinical evidence is being collected Clinical evidence is being collected

24. Questions?

25. Thank You!