Minimally Invasive Surgery (MIS) Hip Joint Replacement is an advancement in hip replacement that offers important advantages over standard surgical procedures. Stryker has partnered with surgeons worldwide to develop MIS procedures and surgical instruments that are designed to help your surgeons do their very best to help you recover your lifestyle. These techniques bring together a wide variety of hip implants, new minimally invasive surgical techniques, and new instrumentation.

Minimally invasive surgery is the use of specialized techniques and instrumentation that allows the physician to perform major surgery with a smaller incision.

The direct anterior approach is one of the minimally invasive techniques used in hip replacement surgery. Continuing orthopaedic experience suggests that this procedure may offer several advantages over the more traditional surgical approaches to hip replacement.1

Traditional hip replacement techniques involve operating from the side (lateral) or the back (posterior) of the hip, which requires a significant disturbance of the joint and connecting tissues and an incision approximately 8-12 inches long. In comparison, the direct anterior approach requires an incision that is only 3-4 inches in length and located at the front of the hip.1 In this position, the surgeon does not need to detach any of the muscles or tendons.1 Some physicians use a special operating room table to help achieve an optimized surgical position for the patient.2

Potential Advantages

The direct anterior approach allows the surgeon good access to the hip without detaching any of the muscles or tendons. This may allow for a more natural return to normal function and activity.1,3

There is also the potential for rehabilitation to be quicker and for hospital length of stay to be decreased because the hip is replaced with minimized detachment of the muscles from the pelvis or femur.4

The smaller incision and reduced muscle disruption indicate that patients may also have a shorter recovery time and less scarring.1 With this approach and the minimization of tissue damage, there may also be less blood loss, less time in surgery and reduced post-operative pain. 1,3,5

Traditional hip replacement techniques require patients to take special hip precautions to prevent dislocation of the prosthesis. These precautions typically include not crossing your legs, not bending your hips more than a right angle, not turning your feet excessively inward or outward and using a pillow between your legs at night when sleeping.6 Following the anterior approach, the risk of dislocation may be reduced. Under their doctor’s supervision, patients may be immediately allowed to move their hips and potentially avoid these cumbersome restrictions.4 They are often encouraged, under the doctor’s supervision, to weight bear immediately and to discard external support as symptoms permit.1 Complications resulting from immobilization have the potential to be reduced due to immediate hip movement and earlier weight-bearing.5

Discuss Your Options With Your Physician

Hip replacement, no matter how minimally invasive, is major surgery and patients are at risk for complications. However, the complication rate following joint replacement surgery is generally very low. Serious complications, such as joint infection, occur in less than 2% of patients.7 (Besides infection, possible complications include blood clots, lung congestion or pneumonia.) The risks that are normally encountered in conventional hip joint replacement remain.

Recovery success depends on several factors including surgeon training and experience, the surgical approach, the implant and the patient’s health and commitment to post-operative physical therapy. Although the direct anterior approach may make sense for some patients, only your surgeon can help you decide what is best for you. Talk with your doctor if you have any questions about the direct anterior approach for total hip replacement or hip replacement in general.

A Giant Step Forward in Knee Replacement

MIS Knee Joint Replacement is a giant step forward in knee replacement for a number of reasons, which may include a shorter hospital stay, less blood loss1 and potentially less scarring.

As you review this website, make a note of anything you don’t understand. Your orthopaedic surgeon will be happy to answer your questions so that you’ll feel comfortable with your chosen treatment plan.

Knee Replacement

Knee replacement is a surgical procedure — performed in the US since the 1960s — in which a diseased or damaged joint is replaced with an artificial joint called a prosthesis. Made of metal alloys and high-grade plastics (which are intended to mimic the function of bone and cartilage, respectively), the prosthesis is designed to move just like a healthy human joint. Over the years, knee replacement techniques and instrumentation have undergone countless improvements. Today, knee replacement is one of the safest and most successful types of major surgery; in well over 90% of cases it is complication-free and results in significant pain relief and restoration of mobility.

MIS Knee Joint Replacement

Minimally Invasive Surgery
Over the past 25 years, minimally invasive surgery has revolutionized many fields of medicine. Its key characteristic is the use of specialized techniques and instrumentation that enable the physician to perform major surgery without a large incision. In this respect, MIS Knee Joint Replacement is indeed “minimally invasive,” requiring only a small incision and potentially causing less trauma to the soft tissues.

MIS Total Knee Replacement (TKR)
Unlike conventional TKR, which requires a large incision (8 to 12 inches) and significant disruption of the muscles and tendons, MIS Knee Joint Replacement is performed through a 3 to 4 inch incision. The amount of soft tissue (muscles and tendons, etc.) that is disrupted during surgery may also be reduced compared to conventional techniques.

MIS Partial Knee Resurfacing (PKR)
Partial Knee Resurfacing (PKR) is a minimally invasive procedure for relieving arthritic knee pain and disability. With PKR, only the damaged surface of the knee joint is resurfaced, potentially minimizing trauma to healthy bone and tissue. PKR implants were developed with patient needs in mind. Because the PKR implants are so much smaller than total knee implants, the surgical incision can be smaller as well.

Potential Advantages
Because fewer muscles and tendons are disturbed with the minimally invasive techniques, their reconstruction is often more natural, wound closure is easier, and recovery may be faster.1 Clinical studies have shown that the midvastus surgical approach used in the MIS technique results in less pain (at both 8 days and 6 weeks after surgery) and quicker restoration of muscle control and strength.2 It may take several months to recover from the large incision and muscle disruption that accompanies the standard approach.1

Risks Associated with Minimally Invasive Surgery
The MIS Knee Joint Replacement technique is less invasive than conventional TKR, but it is still a major surgery. It takes little additional time to complete and may result in advantages for the patient.

As with any major surgical procedure, patients who undergo total joint replacement are at risk for certain complications, the vast majority of which can be successfully avoided or treated. In fact, the complication rate following joint replacement surgery is very low. Serious complications, such as joint infection, occur in less than 2% of patients.3 (Besides infection, possible complications include blood clots, lung congestion, or pneumonia.) The risks that are normally encountered in conventional knee joint replacement remain.

You Don’t Have to Live with Severe Knee Pain

You don’t have to live with severe knee pain and the limitations it may put on your activities. If you haven’t experienced adequate relief with medication or other conservative treatments, MIS Knee Joint Replacement may provide relief from pain and enable you to return to your favorite activities.

For more information visit www.aboutStryker.com and contact your doctor.