Joint Replacement Surgery - Less Invasive, Minimally Invasive

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The New Frontier



               CONFUSED?

                      PERPLEXED?

                                 MYSTIFIED?

                                         MIXED UP?

Allow me to bring some sense to the changing world of joint replacement surgery.



Isn't all surgery invasive in some way? Can surgery ever be noninvasive?

What does invasive actually mean anyway?

Invasive -
Of or relating to a medical procedure in which part of the body is entered, as by puncture or incision.

LESS OR MINIMAL

Is minimal better than less?
Minimal -
Smallest in amount or degree.
Only barely adequate.
Less -
A comparative of little.
A smaller amount.
To a smaller extent or degree.

Does it matter?

Yes, it does.

Limited exposure technique or small window surgery as I like to call it allows me to do your surgery through a very small opening and still achieve an excellent joint replacement outcome.

The small window is not about cosmetics, but much less tissue damage inside, less blood loss, and faster rehabilitation.

The total joint can now be placed in excellent position and alignment through a four to five inch small window in almost all patients.

Because of some patient's body mass index and the severity of their arthritis, small window surgery may not be possible. These are the exceptions, however it does work for most patients.

What you don't read in the newspaper. Read on...

Procedures that utilize more than one incision and are done while exposing the patient and OR staff to a lot of radiation for visualization during the procedure are only done on a selected group of patients based on younger age, smaller size, and degree of arthritis. Less than 20% of patients who want this technique can qualify.

Are two incisions each two inches long better for the patient than one four or five inch incision?

Smaller is definitely better, but how small does the incision need to be? No one really knows for sure.

These new techniques that we are using hold great promise to improve patient outcomes, that is to lessen pain and promote a faster recovery and rehabilitation.

C A O S

On the horizon are many computer assisted orthopaedic surgical technologies (CAOS). The devices include 3 D images, guided and non image based navigation systems, intra-operative fluoroscopic x-ray navigation, and robotic assistive devices.

These new devices and techniques are a new generation of ways to improve patient care. The use of these procedures is limited. Whether they will be come common place in medical practice is unknown.

Whether the definition of minimally (invasive) ie only barely adequate will also apply to these new hip procedures only time will tell.

CAOS may indeed represent the brave new world of orthopaedic joint implant surgery. Stay tuned. On-Line Orthopaedics will keep you informed.