Small Incision Total Hip Replacement

Over the last five to ten years there has been a rapid increase in the use of small incisions for total hip replacement. The most important part of a THR is that the surgeon can see what he or she is doing. This may seem like common sense, but can be compromised by some minimal incision techniques. For example needing X- ray during the procedure to "see" that things are in the right place.

I believe these approaches are a step too far.

For over 5 years now I have undertaken THR through small incisions, between 8cm and 12 cm in length. This is undertaken in all patients where a small incision can be used safely.

The approach I use is a minimal posterior approach which is a modification of the surgical approach I have been using for over 10 years, there is no "learning curve" and visibility is paramount. Dislocation of the hip is often quoted as a reason to avoid this approach but my audited figures show a dislocation rate of 1 - 2%, below those quoted figures for many other approaches.

No major muscles are cut, a limp or lurching gait are uncommon, and it is easily combined with a rapid recovery program to allow same day mobilisation and early discharge where appropriate.

No clips or visible sutures are used, leaving a near invisible scar.