Minimally Invasive Total Hip Replacement
Over time, conditions like arthritis can interfere with your quality of life by decreasing your mobility. Nonsurgical treatments like medications and physical therapy may help to relieve symptoms, but if these treatments are not effective, total hip replacement surgery may be an option.
Total hip replacement surgery has been around for over 40 years, and techniques have continued to evolve over time to produce better and safer results for patients. Dr. Linschoten has over 25 years of experience in orthopaedic surgery and completed his joint replacement fellowship at the world-renowned Cleveland Clinic. He performs total hip replacements on a weekly basis, taking on both primary hip replacements and more complex revision cases.
Candidates for Total Hip Replacement
Total hip replacement is typically recommended when patients have severe hip arthritis, which wears down the cartilage lining of the joint, eventually causing the bones in the joint to rub together. Arthritis pain can interfere with everyday activities like walking, bending, or climbing stairs. The pain may even persist while at rest.
Nonsurgical methods like physical therapy and anti-inflammatory medications are typically recommended first to treat hip arthritis. However, if hip pain persists with these treatments, hip replacement surgery may help to relieve pain and improve mobility. Dr. Linschoten will only recommend hip replacement surgery if he feels it is the best option for the patient’s individual needs.
Total Hip Replacement Procedure
During a total hip replacement procedure, Dr. Linschoten removes the damaged portions of the hip joint and replaces them with prosthetic components. There are several different approaches that may be used for total hip replacement, including popular techniques like the direct anterior approach.
Direct Superior Approach vs. Direct Anterior Approach
The direct anterior approach has been a very popular approach to hip replacement, with many patients specifically requesting the procedure. However, Dr. Linschoten prefers the minimally invasive direct superior approach.
Like the direct anterior approach, the direct superior approach is tissue-sparing, meaning that the muscles are not cut. However, rather than making the incision at the front of the hip, the incision is at the back of the hip. This incision placement has several benefits, including:
- Less scarring - When the incision is at the front of the hip, there is greater tension on the skin, which can produce a more visible scar. This tension is not present at the back of the hip. Furthermore, the direct superior incision is placed in a location that is generally less visible, and the incision is smaller than the incision used for a traditional hip replacement.
- Shorter operation time - A direct superior procedure, on average, takes 20-30% less time to complete. Often, the procedure is done in less than an hour. The direct anterior approach typically takes longer because it is more difficult for the surgeon to access the hip joint from the front.
- Reduced risk of numbness in the thigh - With anterior hip replacement, there is a risk of damage to the lateral cutaneous femoral nerve, which can lead to numbness at the side of the thigh. With the direct superior approach, this risk is eliminated.
- Reduced risk of postoperative complications - Patients who have had a hip replacement with the direct superior approach typically have lower dislocation rates after surgery, compared to other hip replacement approaches.
For these reasons, Dr. Linschoten opts for the direct superior approach for the majority of primary hip replacement cases.
Direct Superior Hip Replacement Procedure
First, Dr. Linschoten will make a small incision at the back of the hip joint. The incision is much smaller and higher than the incision for a typical hip replacement, which reduces scarring after surgery. The position of the incision allows Dr. Linschoten to better view the joint without having to cut any of the muscles. Instead, the muscles can be split along the muscle fibers, which leads to less pain during recovery. Because the muscles are not cut, and the incision is smaller, patients also experience less blood loss during surgery.
Once Dr. Linschoten is able to access the joint, he removes the damaged portions of the bone and cartilage, replacing them with implants. Once the implants are in place, the incision is closed.
Recovering from Total Hip Replacement
Hip replacement surgery typically requires an overnight stay in the hospital. Most patients are able to return home the day after surgery. Though there will be some pain after surgery, many patients notice an improvement in their hip pain right away.
Most patients are able to begin walking within a few days of surgery, either on their own or with a cane. However, it will take about a month to fully recover and resume all normal activities. Patients will participate in physical therapy for 2-3 weeks after surgery, either on an outpatient basis or in-home. Physical therapy helps to strengthen the hip and improve mobility, making it an important part of your recovery process.
Total Hip Replacement in Baton Rouge
Dr. Niels Linschoten has over 25 years of experience in orthopaedic surgery, including total hip replacement. He and his team are happy to answer any questions you may have about hip replacement surgery. If you would like to schedule an appointment with Dr. Linschoten, please call our office at (225) 478-8722, or submit an online appointment request.