Minimal Invasive Hip Resurfacing :
soft tissue release to allow anterior and superior displacement of the head to facilitate accurate reaming of the acetabulum. This allows precise implantation of the definitive acetabular component in its true anteverted and closed position.
Minimally invasive hip resurfacing MIHR® involves a small, cosmetically pleasing incision which is typically 5.5-9 cm in length compared to the incision for the conventional posterior approach which is typically 25-30cm in length.
Hip resurfacing has evolved in the last eight years. The original hip resurfacing replacements were done 30 to 40 years ago and failed because of poor design and materials. Nowadays the design has significantly improved. Hip resurfacing is still a total hip replacement, however, it is more bone conserving leaving the femoral neck and head attached. If the hip fails then a revision standard total hip replacement can be performed without much difficulty.
Resurfacing a hip is similar to a total hip replacement from a surgical perspective. Instead of resecting the arthritic femoral head, the head is reshaped and resurfaced with a metal mushroom-like cap. This is cemented in place. The socket is prepared in a similar fashion to a total hip replacement. The socket is press-fitted into the acetabular bone and bone grows into the socket.
Risks of hip resurfacing replacement are similar to total hip replacement. In addition to those standard risks a hip resurfacing replacement may fail due to a femoral neck fracture or softening of the bone (avascular necrosis).
The advantages of hip resurfacing replacement include reduced dislocation, restores leg lengths, restores “normal anatomy” and the hip appears to be more durable allowing one to perform higher impact activity. The metal on metal technology has been present for the past 30 years and has proved successful.
Minimally invasive hip resurfacing replacement surgery and navigation
Instruments have been designed that allow for smaller incision surgery. This is reflected in less tissue damage and slightly quicker recovery rates. The wounds are also a little smaller. It must be pointed out, however, that six months following the surgery there is no difference in the outcome between a standard incision hip and a mini incision hip.
Navigation is the latest technology that allows more accurate placement of the components to re-establish the normal hip biomechanics. This new technology is still evolving.
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conventional hip resurfacing is carried out through an extensive posterior approach by many surgeons whilst others use an anterolateral or anterior approach. The conventional posterior approach involves quite extensive release of the gluteus maximus insertion to the femur. It also involves extensive