What Are Some Of The Less Invasive Ways To Replace Joints?

— -- Question: What are some of the less invasive ways to replace joints? (small incisions, resurfacing, unicompartmental knee replacement)

Answer: Less invasive options have become increasingly popular in the United States and around the world for both hip and knee replacement.

Over the last five to ten years the incision size itself has probably been reduced 50 percent or more for the average total hip and total knee. That results in less soft tissue damage, less muscle damage, and earlier recovery. All those have been a wonderful advance in orthopedics.

In addition to this there are some specific surgical options that allow surgeons to utilize techniques that involve less invasive options. Specifically on the hip side, hip resurfacing has been introduced since May of 2006.

And with that procedure there is less bone taken from the upper end of the femur. However there is more soft tissues released and I think that's a little bit of a misnomer or misinformation that's been out there in the literature with regard to whether hip resurfacing is less invasive than total hips.

In my opinion and my experience, hip resurfacing and minimally invasive total hips both recover at very rapid rate. In hip resurfacing you spare some bone from the upper end of the femur. But there's more soft tissue release. In minimally invasive hip replacement surgery, more bone is taken from the upper end of the femur but there's less soft tissue release required in most cases. So at the end of the day both those patient groups are recovering much quicker than traditional total hips did, say, 10 or 15 years ago.

On the knee side, again, less invasive surgery, which means smaller incisions, less muscle damage, and early recovery. In addition to that, unicompartmental knee replacement surgery used with increasing freq in the last decade. What I mean by that is replacing only part of the knee. Either the inside or medial compartment, or the outside or lateral compartment.

In addition to this patellofemoral resurfacings have been performed with increasing frequency over the last five to seven years. And that's replacing the knee cap joint or patellofemoral joint of your knee. Each of those options are geared towards addressing the same goal which is early recovery, less pain, and higher degrees of function.

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