How is minimally invasive surgery used in a total hip replacement?

Written by: Mr Senthil Kumar Velayudham
Published: | Updated: 19/06/2023
Edited by: Carlota Pano

Minimally invasive total hip replacement is a highly successful surgical procedure for the majority of patients with a damaged hip joint. Highly esteemed consultant orthopaedic surgeon, Mr Senthil Kumar Velayudham, provides an expert insight into a minimally invasive total hip replacement and explains the important role of an enhanced recovery programme.

Total hip replacement through a minimally invasive approach

 

What is minimally invasive hip replacement?

Minimally invasive surgery involves performing total hip replacement through a smaller skin incision, minimal soft tissue dissection and the restoration of soft tissue anatomy. The incision is typically three to five inches long and the muscles are preserved to achieve a good hip function as much as possible. A better understanding of anatomy and an evolution in the surgical technique and instruments have enabled surgeons to perform hip replacements through minimally invasive technique safely.

 

Total hip replacement can be done through an incision at the back, side or front of the hip. Minimally invasive hip replacement is commonly performed through an incision on the back (posterior approach) or front (anterior approach) of the hip. Each has its own advantages and disadvantages, but there is no evidence so far that overall, one is better than the other. Each surgeon chooses the approach they feel will best achieve good results for their patients.

Minimally invasive hip replacement scar

 

What are the advantages of minimally invasive hip replacement?

The main advantage is preserved muscle function, which helps the patients to achieve excellent function after the hip replacement. Other advantages are less blood loss, less pain and early recovery. However, there are other important factors to consider as well to achieve these goals, such as the selection of appropriate prostheses, good fixation, placement of prostheses in correct angles and the restoration of the anatomy of the patient’s hip in terms of leg length and soft tissue tension.

 

Initially, it was thought that minimally invasive hip replacement was the main reason for early recovery and a short hospital stay after surgery, but more evidence is available now, showing that an enhanced recovery programme which optimises every aspect of patient care is crucial to achieve rapid recovery and a reduced hospital stay after hip replacement.

 

 

Are there any disadvantages of having minimally invasive hip replacement?

There are no specific disadvantages to having minimally invasive hip replacements, as long as the surgeon has the necessary skill and experience for this type of surgery.

 

 

Mr Senthil Kumar Velayudham is a consultant orthopaedic surgeon based in Tunbridge Wells and Crowborough, who specialises in several hip surgeries, including minimally invasive hip replacement, enhanced recovery hip replacement, resurfacing hip replacement, revision hip replacement and hip arthroscopy. If you require a total hip replacement and would like to discuss your options, make sure to visit Mr Velayudham’s Top Doctors profile today.

By Mr Senthil Kumar Velayudham
Orthopaedic surgery

Mr Senthil Kumar Velayudham is a highly esteemed consultant orthopaedic surgeon specialising in hip surgery based in Tunbridge Wells, Kent. He was appointed as consultant orthopaedic surgeon at Maidstone and Tunbridge Wells Hospital in 2006. He also practices at Nuffield Health Tunbridge Wells and Horder Centre, Crowborough, East Sussex.

His special interest includes the treatment of hip arthritis.  He performs high volume minimally invasive hip replacements using techniques that minimise blood loss and allow enhanced recovery. He uses well established high performing prostheses and has excellent long-term results and patient satisfaction as confirmed on National Joint Registry data. Other subspecialty interests include hip impingement, painful hip replacement, failed total hip replacement, hip labral pathology, young adult hip problems, robotics or computer-assisted surgery etc. Commonly performed procedures include revision hip replacement, complex hip replacement, resurfacing hip replacement, custom made hip replacement, robotic hip replacement, hip arthroscopy etc.

Mr Velayudham completed his initial medical studies in India, his medical degree at the University of Chennai in 1990 and his postgraduate study in trauma and orthopaedics at the University of Pune. Soon after, he relocated to the UK and completed further higher surgical training in trauma and orthopaedics at various hospitals including Guy’s and St Thomas' Hospital. In addition, he undertook a fellowship in pelvic and acetabular reconstructive surgery at St George’s Hospital and another in hip reconstructive surgery at the Royal National Orthopaedic Hospital. He is trained in using the latest surgical techniques including computer navigated surgery and robotic hip replacement surgery. Mr Velayudham is clinical governance lead in trauma and orthopaedics for Maidstone and Tunbridge Wells NHS Trust. He chairs the monthly multidisciplinary complex hip and knee meeting and also is a faculty member of the Royal College of London’s training program for trainees in trauma and orthopaedics.

Mr Velayudham’s research interests include bone remodelling around hip prostheses, optimizing hip replacement alignment and bone grafting for acetabular defects. To hear insight from patients treated by Mr Velayudham on their experience, please read the following articles, including on hip replacement surgery and the associated enhanced recovery programme.

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