Hip Replacement Surgery

In the 1960’s Sir John Charnley developed the foundations of modern hip replacement surgery. His designs were the first truly successful hip replacements and have stood the test of time as a credible hip pain treatment. However, in recent years there have been major improvements in the materials used so that now the prostheses are very biocompatible and do not wear or loosen like the early ones did.

Other advancements include better anaesthetic techniques which enable faster rehabilitation. Edward Crawfurd works closely with his anaesthetists to help the patient have a speedy post-operative recovery and a shorter hospital stay.

Mr Crawfurd uses advanced hip replacement surgery, incorporating a ceramic bearing surface which is extremely hard wearing and 10 times smoother than a metal bearing can be.

For many years Edward Crawfurd has been inserting hips through small incisions using a small access posterior approach and more recently a minimal access anterior approach known as AMIS.

Diagram of Hip Replacement
Hip Replacement AMIS Approach

Minimal Access Total Hip Replacement

Also known as mini incision hip replacement

 

Mr Crawfurd is a recognised trainer in the AMIS technique and has had many successfully surgeries over the last 10 years performing this procedure. The AMIS technique is now a preferred treatment method for many surgeons including Mr Edward Crawfurd because of its ability to cause less surgical trauma than other techniques used. Using this technique, Mr Edward Crawfurd can reduce the amount of time required for recovery as no muscles are cut during the surgery.

AMIS can also potentially provide patients with the following benefits:

1. Decreased Recovery Time and Rehabilitation Time [1,3, 4]

In contrast to conventional hip replacement surgery, mini-incision hip replacement dramatically reduces the recovery time post operation. This is a result of the muscles not being cut during the procedure.

As opposed to conventional hip replacement, standing up and practising walking can start almost immediately after surgery, provided your doctor gives you authorisation. This means that patients can practice walking with crutches soon after the surgery is completed, reducing the amount of time it takes to rehabilitate after surgery.

As a large part of recovery is due to the healing of internal soft tissues and surgical wounds, mini-incision hip replacement can be a great way to reduce recovery time, reducing it from approximately 6 months to 6-8 weeks.

 2. Shorter Hospital Stay [2,5]

In many cases, receiving mini-incision hip replacement will result in patient’s hospital stays being dramatically reduced. As the majority of patients are able to start walking with crutches soon after the procedure, patients are allowed to return home much sooner. Although check-ups will be required, patients often find their recovery more pleasant and enjoyable in the comfort of their home.

3. Small Skin Scar [3]

Although a small benefit, many patients will be thankful to have a much smaller scar after their hip surgery.  With AMIS, the incision is much shorter and smaller reducing the amount of scar tissue post-surgery.

4. Faster Return To Daily Activities [5,6,7]

Similar to points 1 and 2, patients who undergo mini-incision hip replacement will be able to recover much quicker than patients undergoing conventional surgery.  This means that patients can return to their daily activities much quicker and enjoy undertakings daily activities.

5. Less Blood Loss [2,3]

The preservation of muscles and vessels means that in the majority of minimal access hip replacement surgeries, blood loss is significantly reduced.  With this procedure, blood transfusions are seldom needed and blood clots in the legs of patients are significantly reduced.

6. Reduced Risk Of Dislocation [4,8]

Minimal access hip replacement significantly reduces the likelihood of hip dislocation. This is a result of the preservation of muscles which largely improves the stability of the hip. The AMIS technique also means that movement post-surgery is not as limited in comparison to conventional hip replacement.  Dislocation is mainly related to posterior hip structure damage, however, AMIS is performed from the front of the body.

7.Prevention Of Limping [9,10,11,12]

Characterised by the surgical procedure that protects muscles, blood vessels and nerves during the exposure of the hip joint, minimal access hip replacement significantly reduces the chances of post-operative limping.

This means that many patients are able to drive after the recovery of their operation, have excellent control of their legs and not take pain medication post rehabilitation. Patients can generally expect a better quality of life after undergoing AMIS treatment instead of conventional surgery. The majority of patients can expect to be able to drive within a month of their operation with the approval of their surgeon.

Summary

The primary goal of minimal access hip replacement is to minimise the harm to muscles, blood vessels and nerves surrounding the joint. This approach for surgery significantly reduces potential risks associated with surgery such as blood loss and helps aid recovery and rehabilitation. AMIS can provide patients with a better quality of life post-surgery enabling them to enjoy everyday activities.

Hip Replacement

References

[1] Arthroplastie totale de hanche par voie antérieure et son évolution mini-invasive; F. Laude et al.; EMC; 2004, 44-667-B

[2] Single-incision anterior approach for total hip arthroplasty on an orthopaedic table; JM Matta et al; Clin Orthop Relat Res, 2005 Dec, (441): 115-24

[3] Minimally Invasive total hip arthroplasty: anterior approach; F. Rachbauer; Orthopäde, 2006 Jul;35(7):723-4, 726-9

[4] Mini-incision anterior approach does not increase dislocation rate: a study of 1037 total hip Replacement; T Siguier et al; Clin Orthop Relat Res, 2004 Sep, (426): 164-73

[5] What‘s new in hip arthroplasty; MH Huo et al; JBJS Am; 2005 Sep, 87(9):2133-46

[6] Rapid Rehabilitation and recovery with minimally invasive total hip arthroplasty; RA Berger et al; Clin Orthop Relat Res, 2004, (429): 239-247

[7] The minimally invasive anterior approach to hip arthroplasty; RE Kennon et al; Orthopäde, 2006 Jul, 35 (7): 731-7

[8] Dislocation after hip hemiarthroplasty: anterior versus posterior capsular approach.; JB Bush et al; Orthopedics. 2007 Feb;30(2):138-44

[9] Muscular damage after total hip arthroplasty: conventional versus minimally invasive anterior approach.; Dr Dora, Dr Kalberer; AOA 2008, Australia, Hobart

[10] Abductor Tendons and Muscles Assessed at MR Imaging after Total Hip Arthroplasty in Asymptomatic and Symptomatic Patients. C. Pfirmann et al., Radiology 2005, 235: 969-976.

[11] MR imaging of the abductor tendons and muscles after total hip replacement in asymptomatic and symptomatic patients. PD Dr. Dora, EFORT 2007

[12] Der anteriore Zugang für die minimal-invasive HTEP. C Dora; Leading Opinions Sept 2006, 1/2006