Skip to main content

Minimally Invasive Total Hip Arthroplasty

  • Chapter
  • First Online:
Hip Arthroplasty

Abstract

Surgical advances and a better understanding of the hip anatomy permitted surgeons to explore minimally invasive approaches (MIS) to hip replacement. There are numerous benefits to this technique including shorter hospitalisation and faster rehabilitation. However, MIS techniques reduce the visualisation of the operating field, and specialised instrumentation is required to optimise implant position. There is a steep learning curve for this technique, and the surgeon’s volume correlates with patient outcome. Computer-assisted orthopaedic surgical strategies were originally developed to enhance the placement of implants by conventional methods, but they are now utilised to improve the outcome of minimally invasive surgery. This chapter outlines the senior author’s experience in the use of the posterior minimally invasive approach to the hip and shares the surgical pearls to improve outcomes.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 189.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 249.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Learmonth ID, Young C, Rorabeck C. The operation of the century: total hip replacement. Lancet. 2007;370:1508.

    Article  PubMed  Google Scholar 

  2. Siddiqui NA, Mohandas P, Muirhead-Allwood S, Nuthall TA. A review of minimally invasive hip replacement surgery—current practice and the way forward. Curr Orthop. 2005;19(5):247–54.

    Article  Google Scholar 

  3. Malik A, Dorr LD. The science of minimally invasive total hip arthroplasty. Clin Orthop Relat Res. 2007;463:74.

    Article  PubMed  Google Scholar 

  4. Dorr LD, Maheshwari AV, Long WT, Wan Z, Sirianni LE. Early pain relief and function after posterior minimally invasive and conventional total hip arthroplasty: a prospective, randomized, blinded study. J Bone Joint Surg Am. 2007;89:1153.

    Article  PubMed  Google Scholar 

  5. Berry DJ, Berger RA, Callaghan JJ, Dorr LD, Duwelius PJ, Hartzband MA, et al. Minimally invasive total hip arthroplasty: development, early results, and a critical analysis. J Bone Joint Surg Am. 2003;85:2235.

    Article  PubMed  Google Scholar 

  6. Howell JR, Garbuz DS, Duncan CP. Minimally invasive hip replacement: rationale, applied anatomy, and instrumentation. Orthop Clin N Am. 2004;35:107.

    Article  Google Scholar 

  7. Judet H. Mini-invasive approach and navigation in total prosthesis of the hip. In: Mini-invasive surgery of the hip. Springer; 2014.

    Google Scholar 

  8. Sculco TP, Jordan LC, Walter WL. Minimally invasive total hip arthroplasty: the Hospital for Special Surgery experience. Orthop Clin N Am. 2004;35:137.

    Article  Google Scholar 

  9. DiGioia AM, Plakseychuk AY, Levison TJ, Jaramaz B. Mini-incision technique for total hip arthroplasty with navigation. J Arthroplast. 2003;18:123.

    Article  Google Scholar 

  10. Bal BS, Haltom D, Aleto T, Barrett M. Early complications of primary total hip replacement performed with a two-incision minimally invasive technique. Surgical technique. J Bone Joint Surg Am. 2006;88:221.

    Article  PubMed  Google Scholar 

  11. Ogonda L, Wilson R, Archbold P, Lawlor M, Humphreys P, O’Brien S, et al. A minimal-incision technique in total hip arthroplasty does not improve early postoperative outcomes: a prospective, randomized, controlled trial. J Bone Joint Surg Am. 2005;87:701.

    Article  PubMed  Google Scholar 

  12. Berstock JR, Blom AW, Beswick AD. A systematic review and meta-analysis of the standard versus mini-incision posterior approach to total hip arthroplasty. J Arthroplasty. 2014;29:1970.

    Article  PubMed  Google Scholar 

  13. Gérard R, Savéan J, Lefèvre C. Minimally invasive posterolateral hip approach with SPARTAQUUS (Spare the Piriformis And Respect The Active QUadratus femoris and gluteus mediUS) technique. Rev Chir Orthop Traumatol. 2020;106:1523.

    Google Scholar 

  14. Hanly RJ, Sokolowski S, Timperley AJ. The SPAIRE technique allows sparing of the piriformis and obturator internus in a modified posterior approach to the hip. Hip Int. 2017;27:205.

    Article  PubMed  Google Scholar 

  15. Siguier T, Siguier M, Brumpt B. Mini-incision anterior approach does not increase dislocation rate: a study of 1037 total hip replacements. Clin Orthop Relat Res. 2004;426:164.

    Article  Google Scholar 

  16. Anil Kumar PG, Kirmani SJ, Humberg H, Kavarthapu V, Li P. Reproducibility and accuracy of templating uncemented THA with digital radiographic and digital TraumaCad templating software. Orthopedics. 2009;32:815.

    Article  Google Scholar 

  17. Pullen WM, Whiddon DR. Accuracy and reliability of digital templating in primary total hip arthroplasty. J Surg Orthop Adv. 2013;22:148.

    Article  PubMed  Google Scholar 

  18. Hsu AR, Kim JD, Bhatia S, Levine BR. Effect of training level on accuracy of digital templating in primary total hip and knee arthroplasty. Orthopedics. 2012;35:e179–83.

    Article  PubMed  Google Scholar 

  19. Berger RA. Total hip arthroplasty using the minimally invasive two-incision approach. Clin Orthop Relat Res. 2003;417:232.

    Article  Google Scholar 

  20. Pagnano MW, Trousdale RT, Meneghini RM, Hanssen AD. Slower recovery after two-incision than mini-posterior-incision total hip arthroplasty: a randomized clinical trial. J Bone Joint Surg Am. 2008;90:1000.

    Article  PubMed  Google Scholar 

  21. Lei T, Qian H, Ye Z, Lei P, Hu Y. Is two-incision approach superior to the mini-posterior approach in total hip arthroplasty?: a meta-analysis. ANZ J Surg. 2021;91:E271–9.

    Article  PubMed  Google Scholar 

  22. Chimento GF, Pavone V, Sharrock N, Kahn B, Cahill J, Sculco TP. Minimally invasive total hip arthroplasty: a prospective randomized study. J Arthroplast. 2005;20:139.

    Article  Google Scholar 

  23. Lewinnek GE, Lewis JL, Tarr R, Compere CL, Zimmerman JR, Lewinnek BYGE, et al. Dislocations after total arthroplasties*. J Bone Joint Surg Am. 1978;60:217.

    Article  CAS  PubMed  Google Scholar 

  24. Duwelius PJ, Dorr LD. Minimally invasive total hip arthroplasty: an overview of the results. Instr Course Lect. 2008;57:215.

    PubMed  Google Scholar 

  25. Pfeil J, Siebert WE. Minimally invasive surgery in total hip arthroplasty. Springer; 2010.

    Book  Google Scholar 

  26. Tan TL, Shohat N, Rondon AJ, Foltz C, Goswami K, Ryan SP, et al. Perioperative antibiotic prophylaxis in total joint arthroplasty: a single dose is as effective as multiple doses. J Bone Joint Surg Am. 2019;101:429.

    Article  PubMed  Google Scholar 

  27. Warren JA, Sundaram K, Anis HK, Kamath AF, Higuera CA, Piuzzi NS. Have venous thromboembolism rates decreased in total hip and knee arthroplasty? J Arthroplast. 2020;35:259.

    Article  Google Scholar 

  28. Swanson TV. Early results of 1000 consecutive, posterior, single-incision minimally invasive surgery total hip arthroplasties. J Arthroplasty. 2005;20:26.

    Article  PubMed  Google Scholar 

  29. Speirs AD, Heller MO, Taylor WR, Duda GN, Perka C. Influence of changes in stem positioning on femoral loading after THR using a short-stemmed hip implant. Clin Biomech. 2007;22:431.

    Article  Google Scholar 

  30. van Oldenrijk J, Molleman J, Klaver M, Poolman RW, Haverkamp D. Revision rate after short-stem total hip arthroplasty: a systematic review of 49 studies. Acta Orthop. 2014;85:250.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Chang J-D, Kim I-S, Bhardwaj AM, Badami RN. The evolution of computer-assisted total hip arthroplasty and relevant applications. Hip Pelvis. 2017;29:1.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. DiGioia AM, Blendea S, Jaramaz B, Levison TJ. Less invasive total hip arthroplasty using navigational tools. Instr Course Lect. 2004;53:157–64.

    PubMed  Google Scholar 

  33. Buller LT, McLawhorn AS, Romero JA, Sculco PK, Mayman DJ. Accuracy and precision of acetabular component placement with imageless navigation in obese patients. J Arthroplast. 2019;34:693.

    Article  Google Scholar 

  34. Illgen RL, Bukowski BR, Abiola R, Anderson P, Chughtai M, Khlopas A, et al. Robotic-assisted total hip arthroplasty: outcomes at minimum two-year follow-up. Surg Technol Int. 2017;30:365.

    PubMed  Google Scholar 

  35. Dorr LD, Thomas D, Long WT, Polatin PB, Sirianni LE. Psychologic reasons for patients preferring minimally invasive total hip arthroplasty. Clin Orthop Relat Res. 2007;458:94.

    Article  PubMed  Google Scholar 

  36. Migliorini F, Biagini M, Rath B, Meisen N, Tingart M, Eschweiler J. Total hip arthroplasty: minimally invasive surgery or not? Meta-analysis of clinical trials. Int Orthop. 2019;43:1573.

    Article  PubMed  Google Scholar 

  37. Cheng T, Feng JG, Liu T, Zhang XL. Minimally invasive total hip arthroplasty: a systematic review. Int Orthop. 2009;33:1473.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  38. Levine MJ, West K, Michelson J, Manner P. Retrospective comparison of two-incision total hip arthroplasty with a standard direct lateral approach: a single surgeon’s experience. Semin Arthroplast. 2007;18:268.

    Article  Google Scholar 

  39. Flören M, Lester DK. Durability of implant fixation after less-invasive total hip arthroplasty. J Arthroplast. 2006;21:783.

    Article  Google Scholar 

  40. Lawlor M, Humphreys P, Morrow E, Ogonda L, Bennett D, Elliott D, et al. Comparison of early postoperative functional levels following total hip replacement using minimally invasive versus standard incisions. A prospective randomized blinded trial. Clin Rehabil. 2005;19:465.

    Article  PubMed  Google Scholar 

  41. Berend KR, Lombardi AV, Berend ME, Adams JB, Morris MJ. The outpatient total hip arthroplasty: a paradigm change. Bone Joint J. 2018;100-B:31.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  42. Mason JB. The new demands by patients in the modern era of total joint arthroplasty: a point of view. Clin Orthop Relat Res. 2008;466:146.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Pollock M, Somerville L, Firth A, Lanting B. Outpatient total hip arthroplasty, total knee arthroplasty, and unicompartmental knee arthroplasty: a systematic review of the literature. JBJS Rev. 2016;4:e4.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Venu Kavarthapu .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2023 The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Wek, C., Massa, E., Kavarthapu, V. (2023). Minimally Invasive Total Hip Arthroplasty. In: Sharma, M. (eds) Hip Arthroplasty. Springer, Singapore. https://doi.org/10.1007/978-981-99-5517-6_9

Download citation

  • DOI: https://doi.org/10.1007/978-981-99-5517-6_9

  • Published:

  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-99-5516-9

  • Online ISBN: 978-981-99-5517-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics