Minimally Invasive Surgery (MIS)
The surgeons at the Center for Total Joint Replacement at the Palo Alto Medical Foundation (PAMF) perform minimally invasive hip and knee replacement surgery. Minimally invasive surgery (MIS) involves smaller incision. For example, a traditional knee replacement requires a 6- to 12-inch-long incision, while MIS is performed with only a 4- to 5-inch incision.
Potential Advantages of MIS:
- Less blood loss
- Less trauma to the surrounding tissues
- Shorter hospital stays
- Generally earlier rehabilitation
Individuals who are obese or who have had previous hip or knee surgery are generally not suitable candidates. The decision to have this type of surgery must be made after a careful evaluation by the surgeons, and a discussion of the risks and benefits of MIS compared to traditional joint replacement.
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Minimally Invasive Hip Replacement
Minimally invasive hip replacement surgery was created to allow surgeons to replace the hip through one or two smaller incisions. When the surgical incisions are smaller, fewer muscles and tendons are traumatized, which helps in a quicker recovery for the patient. It also means less blood loss.
A single minimally invasive hip incision may measure only 3 to 6 inches, depending on the size of the patient and the difficulty of the procedure. This incision is usually placed over the outside of the thigh. Muscles and tendons are split or detached to a lesser extent than in the traditional hip replacement operation.
The artificial implants being used for the minimally invasive hip replacement procedures are the same as those used for traditional hip replacement.
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Minimally Invasive Total Knee Replacement
Minimally invasive total knee replacement is a technique developed to minimize the negative effect on the quadricep muscle (the muscle that runs across the front of your thigh). When you straighten out your knee while you are sitting, you feel this powerful muscle working. The center of the quadricep muscle is the quadricep tendon, which provides much of the power to the knee joint.
In traditional knee replacement surgery, this muscle and tendon group is usually split lengthwise to gain access to the knee. It is sewn and repaired at the end of the surgery. In minimally invasive knee replacement surgery, the knee joint is accessed without cutting through the quadricep tendon. Patients have found they experience less pain and a quicker recovery with this type of surgery.
MIS should not be confused with arthroscopic procedures that treat torn cartilage and require only very small incisions. In MIS procedures, surgeons still must make an incision large enough to insert the knee implant - usually 4 to 5 inches long.
This type of surgery is still relatively new and medical research has not determined how the long-term results compare to traditional surgery.
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References
Minimally Invasive Total Knee Replacement, AAOS.
Minimally Invasive Hip Replacement", AAOS.
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