Total Hip Arthroplasty & Minimally Invasive Techniques

Total hip arthroplasty is one of the most common and effective surgeries to restore functionality and relieve pain in patients with degenerative diseases of the hip joint, such as osteoarthritis or other conditions that lead to cartilage degeneration.

Total hip arthroplasty (or hip replacement) is a surgery in which the damaged hip joint is removed and replaced with an artificial implant (prosthesis). The result of the operation is pain relief and restoration of mobility in the hip area, allowing the patient to return to daily activities with an improved quality of life.

The main goal of total hip arthroplasty is to relieve pain caused by degenerative hip alteration. This procedure restores joint function, enabling the patient to walk painlessly, climb stairs, and participate in daily activities without restrictions.

• Ability to relieve the patient of severe discomfort and pain.
• Improvement of mobility and quality of life.
• Restoration of the possibility of participation in physical activities.
• Elimination of difficulty in movement due to limited joint functionality.

The procedure of total hip arthroplasty involves removing the damaged head of the thigh and the superficial part of the pelvis and replacing them with artificial materials. Implants are extremely durable and can last for decades. The operation is performed under general anesthesia and requires hospitalization.

Rehabilitation after total arthroplasty includes physiotherapy and careful planning of the rehabilitation program to enhance hip functionality and reduce the risk of complications.

In recent years, the evolution of medical technology has brought to the fore the minimally invasive methods for total arthroplasty. These methods aim to reduce the recovery time and the operation itself required to replace the joint. Instead of large incisions, the minimally invasive technique uses smaller incisions and often techniques of supportive monitoring of the invasive act with the help of robotics and other modern tools.

1. Smaller incision: A smaller incision results in less bleeding and a reduced risk of infection.
2. Fasterrecovery: Patients usually return to their daily activities faster than with the traditional surgical method.
3. Less pain after surgery: Because the trauma is smaller, the pain is less and the need for medication is reduced.
4. Less hospitalization time: Patients have the opportunity to return home earlier and continue their rehabilitation.

In recent years, the evolution of minimally invasive techniques and the use of robotic technology offers significant advantages to patients, including faster recovery and reduction of complications.

The Micro Hip technique  is an anterior minimally invasive approach that is characterized by the aabsence of trauma. The main reason why this method is widely accepted is that the surgical incision is small and, most importantly, does not require the cutting or detachment of muscles, which ensures that the functionality of the tissues around the joint is maintained.

Advantages:

• Minimization of pain:Due to the small incision and non-traumatic access, patients report less pain after surgery.
• Limited blood loss: The smaller incision and the absence of muscle cutting significantly reduce blood loss.
• Shortening hospitalization time:Patients recover faster and return home earlier.
• Reducing the risk of dislocation:Preserving the muscles and ligaments around the hip reduces the risk of dislocation and enhances joint stability.
• Smooth gait:Because the muscles remain intact, patients return to normal gait faster without lameness.
• Faster return to daily activities:Normal hip mobility helps the patient to return to their activities faster.

The STAR technique  is another minimally invasive approach to hip arthroplasty, which ensures very good functionality due to the gentle access to the surrounding tissues and muscles. With a small incision, this approach is extremely gentle and non-traumatic, allowing for quick rehabilitation and improved results.

Advantages:

• Minimization of postoperative pain: A gentle approach to the tissues significantly reduces postoperative pain.
• Minimizeinpatient hospitalization: Patients recover faster, reducing hospital stay.
• Minimize blood loss: Small incision and non-traumatic access reduce bleeding.
• Maintaining muscle functionality:The muscles around the joint remain intact, allowing for faster recovery and a return to activities.

The SuperPath method involves creating a corridor around the hip joint, holding the muscles and tissues without injuring them. This technique requires a small incision in the back of the hip, while the synovial bursa (articular capsule) remains intact. This results in greater joint stability and a more natural feeling after surgery.

Advantages:

• Minimization of postoperative pain:Thanks to minimal traumatic surgery, postoperative pain is minimized.
• Minimize hospitalization: Patients recover faster, reducing hospitalization time.
• Immediate patient mobilization:Patients can move earlier, reducing the chances of complications due to immobility.
• No restriction on movement:This technique allows the patient to quickly return to daily activities without restrictions on movement.

The AMIS method (Minimally Invasive Arthroplasty) involves a small incision (less than 10 cm) and keeps the muscles and tendons around the joint intact. This means that patients recover faster and the pain after the operation is very limited. Because it does not require cutting muscles or tendons, the complications are much fewer, and the hospitalization time is extremely short.

Advantages:

• Minimization of pain after surgery.
• Zero blood loss:Small incision and minimal tissue damage limit blood loss.
• Shortening hospitalization time:A quick recovery means that patients return home quickly and at their daily pace.
• Faster return to activities.

With the use of robotic technology, the procedures become even more precise and effective. Two important robotic assistance systems in total hip arthroplasty are ROSA and Naviswiss.

1. ROSA

ROSA  is an advanced robotic system that helps perform total hip arthroplasty with exceptional precision. This system adapts to the surgeon’s technique and avoids undue tissue loss, offering improved functionality and faster recovery.

2. Naviswiss

Naviswiss is a portable navigation system that offers surgeons useful information on the exact placement of the implant. This system can be used with any access and offers excellent results, reducing the chances of complications and offering more accurate results.

5. Custom Hips

The Custom Hips method or personalized hip arthroplasty uses a customized, tailor made implant that fits perfectly to the patient’s anatomy. This allows for optimal implant placement and better joint functionality. Adjusting this procedure to the unique anatomic needs of the patient contributes to better rehabilitation and minimization of postoperative problems.

Modern hip arthroplasty, with its minimally invasive techniques and the help of robotic technology, has improved the quality of life of many patients. The choice of the appropriate method depends on the patient’s condition and needs, and the specialized doctor will suggest the most suitable solution for the best possible result.