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Minimally Invasive Surgery

We have maintained an active interest in optimizing, and accelerating patient recovery from surgery.  This may be achieved by limiting the amount of tissue injury, and diminishing post-operative inflammation and pain. Numerous “minimally invasive” operative approaches have been proposed for hip and knee surgery, and have been heavily marketed in the press and the internet.  Despite claims of markedly improved recovery times, when subjected to rigorous, comparative scientific study, most studies have shown minimal or no benefit, and in some studies, worse outcomes.

We remain committed to the evolution of surgical technique, and more importantly, to the proper comparative study of these techniques to identify those which truly optimize patient recovery, outcomes, and implant longevity.  We are currently involved in a study which tracks the milestones in recovery achieved with different surgical techniques in different clinical settings in order to better understand the best way to approach each individual patient.

Total Hip Replacement

We utilize 3 different techniques in approaching the hip for total hip replacement.  The choice is made based on the individual anatomy of the patient, and associated clinical details.

Abbreviated Posterior Approach

With this technique the lower portions of the traditional posterior exposure has been diminished, with less muscle dissection.  Specially designed instruments allow bone preparation and implant insertion with reproducibility.  The posterior capsule and 3 small tendons are repaired to their anatomic positions.

Percutaneous Assisted Total Hip (PATH)

This technique uses a percutaneous instrumentation to further limit dissection of the lower portion of the incision, with direct access to the socket achieved with through a cannula (metal tube) placed while preserving most of the posterior tendons of the hip.

An animation of the surgical technique can be viewed on the right

Direct Anterior Approach

The Direct Anterior Approach to the hip allows a preservation of all of the muscle attachments to the hip, in most cases simply retracting them away, and allowing a return to an anatomic position without the need for repair.  One benefit to this approach is fewer restrictions in post operative motion, because the tendons the prevent dislocation remain intact.

An animation of the surgical technique can be viewed on the right

Total Hip Replacement VIDEO

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