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Mini-Posterolateral Total Hip Replacement

Alternative name: Minimally Invasive Total Hip Replacement; Minimally Invasive Total Hip Arthroplasty

What is the mini-posterolateral total hip replacement?

This technique for total hip replacement is still in its infancy and some studies* suggest that it may not be as effective in all cases as other approaches to the procedure. The mini-posterolateral approach is a technique that allows the surgeon to perform total hip replacement through a relatively small incision, and without cutting the important abductor muscles that are so critical to hip stability and walking. As a result, with successful surgery, patients may put their full weight on the operated leg immediately after surgery.

* See the article "Minimally Invasive" Total Hip Arthroplasty, Daniel J. Berry, MD, associate editor, Journal of Bone and Joint Surgery (American), April 2005

See other references below.

Why would a doctor recommend this approach?

This procedure is equivalent to the total hip replacement. Patients who suffer from obesity are not normally considered for this procedure. The surgery is technically demanding and not all patients are recommended for this hip replacement method. The decision to use this technique is made on a case-by-case basis and patients should talk through the pros and cons with their doctor.

What does mini-posterolateral total hip replacement involve?

Many of the preparations for surgery are covered in the Total Hip Replacement Guide and on the page describing total hip replacement. Using the mini posterolateral approach, hip replacement can be performed through an incision measuring 3 to 5 inches in most patients. Individuals who are very muscular, obese, or have severe deformity of the hip joint may not be candidates for hip replacement using this technique.

How long is the recovery after a mini-posterolateral total hip replacement?

At first, crutches or a walker are needed for balance but within a few days or weeks patients may start using a cane. By the time patients return to the clinic for their 6 week checkup, most are walking without a cane or crutch.

Selected references:

Wright JM, Crockett HC, Delgado S, Lyman S, Madsen M, Sculco TP. Mini-incision for total hip arthroplasty: a prospective, controlled investigation with 5-year follow-up evaluation. J Arthroplasty. 2004 Aug;19(5):538-45.

Sculco TP, Jordan LC. The mini-incision approach to total hip arthroplasty. Instr Course Lect. 2004;53:141-7. Review.

Sculco TP, Jordan LC, Walter WL. Minimally invasive total hip arthroplasty: the Hospital for Special Surgery experience. Orthop Clin North Am. 2004 Apr;35(2):137-42.

Martinez AA, Herrera A, Cuenca J, Panisello JJ, Tabuenca A. Comparison of two different posterior approaches for hemiarthroplasty of the hip. Arch Orthop Trauma Surg. 2002 Feb;122(1):51-2.

Pellicci PM, Bostrom M, Poss R. Posterior approach to total hip replacement using enhanced posterior soft tissue repair. Clin Orthop. 1998 Oct;(355):224-8.

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