Minimally Invasive Hip Replacement - Direct Superior Approach
We understand that making sure you know what to expect from the hip replacement experience is important to you. If you have additional questions as you are reading through this material, please reach out to us to discuss.
Diagnosis and Treatment of Hip Pain
Each patient is unique, and can experience hip pain for different reasons. It's important to talk to us about the cause of your hip pain so you can understand the treatment options available to you. One common cause of hip pain is arthritis, a degenerative condition that involves the breakdown of cartilage and bones in the hip joint. Pain from arthritis and joint degeneration can be constant or come and go, occur with movement or after a period of rest, or be located in one spot or many parts of the body. If you haven't experienced adequate relief with medication and other conservative treatments, hip replacement may provide you with relief from your arthritis.
Total Hip Replacement
Total hip replacement involves removing arthritic bone and damaged cartilage in the hip joint, and replacing them with an implant. The hip joint is generally described as a ball-and-socket joint. Take a look at how the end of the thigh bone (femoral head) is replaced with a metal stem and an artificial ball that is secured to the top of the stem. The hip socket (acetabulum) is reconstructed, typically using a metal cup lined with a durable plastic (polyethylene). The femoral and acetabular components work together to form the artificial hip implant.
Direct Superior Approach
Your surgery may be performed using the Direct Superior Approach, a minimally invasive surgical technique used in total hip replacement. This technique may be associated with:
What are the differences between the Direct Superior Approach and a traditional hip replacement? One difference is the location of the incision. During a traditional hip replacement, the surgeon will make an incision through the IT band, which is a muscle that extends down the outside of your leg from the pelvis to the knee. In a Direct Superior procedure, the surgeon avoids cutting the IT band.1 Another difference is the length of the incision. Traditional hip replacement may require an 10-12 inch incision4 while the incision used in the Direct Superior Approach may be 3-6 inches in length.1
Hip joint replacement is intended for use in individuals with joint disease resulting from degenerative and rheumatoid arthritis, avascular necrosis, fracture of the neck of the femur or functional deformity of the hip.
Joint replacement surgery is not appropriate for patients with certain types of infections, any mental or neuromuscular disorder which would create an unacceptable risk of prosthesis instability, prosthesis fixation failure or complications in postoperative care, compromised bone stock, skeletal immaturity, severe instability of the joint, or excessive body weight.
Like any surgery, joint replacement surgery has serious risks which include, but are not limited to, pain, bone fracture, change in the treated leg length (hip), joint stiffness, hip joint fusion, amputation, peripheral neuropathies (nerve damage), circulatory compromise (including deep vein thrombosis (blood clots in the legs)), genitourinary disorders (including kidney failure), gastrointestinal disorders (including paralytic ileus (loss of intestinal digestive movement)), vascular disorders (including thrombus (blood clots), blood loss, or changes in blood pressure or heart rhythm), bronchopulmonary disorders (including emboli, stroke or pneumonia), heart attack, and death.
Implant related risks which may lead to a revision of the implant include dislocation, loosening, fracture, nerve damage, heterotopic bone formation (abnormal bone growth in tissue), wear of the implant, metal sensitivity, soft tissue imbalance, osteolysis (localized progressive bone loss), audible sounds during motion, and reaction to particle debris.
The information presented is for educational purposes only. Speak to your doctor to decide if joint replacement surgery is appropriate for you. Individual results vary and not all patients will return to the same activity level. The lifetime of any joint replacement is limited and depends on several factors like patient weight and activity level. Your doctor will counsel you about strategies to potentially prolong the lifetime of the device, including avoiding high-impact activities, such as running, as well as maintaining a healthy weight. It is important to closely follow your physician's instructions regarding post-surgery activity, treatment and follow-up care. Ask your doctor if a joint replacement is right for you.
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- Roger, D. J., & Hill, D. (2012). Minimally Invasive Total Hip Arthroplasty Using a Transpiriformis Approach: A Preliminary Report. Clinical Orthopaedics and Related Research, 470(1).
- Penenberg BL, Bolling WS, Riley M. Percutaneously assisted total hip arthroplasty (PATH): a preliminary report. J Bone Joint Surg Am. 2008;90(suppl 4):209-220
- Khan RJ, Fick D, Khoo P, Yao F, Nivbrant B, Wood D. Less invasive total hip arthroplasty: description of a new technique. J Arthroplasty. 2006;21:1038-1046.
- AAOS website, http://orthoinfo.aaos.org/topic.cfm?topic=a00404, accessed March 2016.
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