Minimally Invasive Total Hip Arthroplasty With Two Incisions

Minimally invasive surgery has the potential for minimizing surgical trauma, pain, and recovery. This manuscript discusses minimally invasive hip arthroplasty through a two-incision technique: one incision is for the acetabular component, the other is for the femoral component. Specialized instruments and fluoroscopy ensure the proper starting points for the incisions and accurate component position and alignment. In 200 consecutive patients that were carefully selected, a comprehensive perioperative management pathway was developed and implemented around this two-incision technique of minimally invasive hip replacement. Of the 200 patients in this study, 192 (96%) were discharged to home the day of surgery. The minimally invasive two-incision total hip technique described here, where muscle and tendon trauma is minimized, shows substantial short-term pain and functional improvement over traditional hip replacement. While this minimally invasive two-incision technique shows great promise, this technique requires meticulous surgical technique, specialized instrumentation, and special instruction.