1. Minimally Invasive Hip Surgery

2. What is Minimally Invasive Hip Surgery? A new surgical technique A new surgical technique Uses traditional hip implants. Uses traditional hip implants. Two different techniques, including mini-incision and two-incision. Two different techniques, including mini-incision and two-incision.

3. Traditional VS Minimally Invasive Hip Replacement Surgery Traditional Hip Replacement Surgery Traditional Hip Replacement Surgery Proven in clinical studies and successfully performed for decades Proven in clinical studies and successfully performed for decades Allows surgeon full visualization of operative area Allows surgeon full visualization of operative area Larger incision (8-10 inches) Larger incision (8-10 inches) More disruption of muscles and tissues More disruption of muscles and tissues Minimally Invasive Hip Replacement Surgery Long-term effects and success are not established. Restricted visualization of operation area. Smaller incisions (2-4 inches) Potentially less disruption of muscles and tissues May lead to less blood loss and postoperative pain

4. Traditional VS Minimally Invasive Hip Replacement Surgery Traditional Hip Replacement Surgery Traditional Hip Replacement Surgery Average hospital stay is five days Average hospital stay is five days Average recovery time of approx. 3 months (individuals will vary) Average recovery time of approx. 3 months (individuals will vary) Minimally Invasive Hip Replacement Surgery May lead to a shortened hospital stay, less than 5 days. May reduce recovery time

5. Traditional VS Minimally Invasive Hip Replacement Surgery Traditional Hip Replacement Surgery Traditional Hip Replacement Surgery Minimally Invasive Hip Replacement Surgery

6. Benefits of Minimally Invasive Hip Surgery Less trauma to the body. Less trauma to the body. Healing and rehabilitation potentially quicker. Healing and rehabilitation potentially quicker. Shorter hospital stays Shorter hospital stays Allows for immediate stability of the hip Allows for immediate stability of the hip Lower risk of dislocation. Lower risk of dislocation. Potentially less postoperative pain. Potentially less postoperative pain. Cosmetically appealing Cosmetically appealing

7. Ideal Candidate Suffering from hip arthritis Suffering from hip arthritis Failed response to: Failed response to: Medicines Medicines Exercise Exercise Weight-management Weight-management Deciding factors include: Deciding factors include: Medical history Medical history Weight Weight General health General health Body structure, including bone structure Body structure, including bone structure Extent and pattern of arthritis Extent and pattern of arthritis

8. Inappropriate Candidates Severely obese (BMI of 40 or greater) Severely obese (BMI of 40 or greater) Very muscular Very muscular Undergoing complex revision surgeries Undergoing complex revision surgeries

9. Minimally Invasive Hip Techniques Two-Incision 2 incisions 2 incisions Approximately 2 inches in length Approximately 2 inches in length On both front and rear of thigh On both front and rear of thigh Fluoroscopy may be used. Fluoroscopy may be used. Mini-Incision 1 incision Approximately 3 to 4 inches in length Either front or rear of thigh Fluoroscopy is not used.

10. Techniques: Two Incision vs Mini Incision Two-Incision Mini-Incision

11. Fluoroscopy Real-time x-ray images to define instruments positions during surgery. Real-time x-ray images to define instruments positions during surgery. Guides position of implants Guides position of implants Sometimes used with smaller incisions. Sometimes used with smaller incisions.

12. Fluoroscopy: Benefits and Risks Benefits: Benefits: Increases surgical accuracy Increases surgical accuracy Safer and shorter procedure. Safer and shorter procedure. Risks: Risks: Increased radiation exposure Increased radiation exposure Minimal long term effects Minimal long term effects

13. Recovery After Surgery MIH benefits shown in the first 3 months of recovery MIH benefits shown in the first 3 months of recovery Patient must follow hip precautions: Patient must follow hip precautions: Not crossing their legs Not crossing their legs Take care when bending Take care when bending Avoid high-impact and contact sports. Avoid high-impact and contact sports.

14. Risk Factors Factors that may affect the rate of complications including Factors that may affect the rate of complications including Surgeon skill Surgeon skill Weight, age and overall health of the patient Weight, age and overall health of the patient Current lifestyle and activities of the patient Current lifestyle and activities of the patient Presence of osteoporosis or other conditions that weaken bones Presence of osteoporosis or other conditions that weaken bones Patient compliance with physician instructions Patient compliance with physician instructions

15. Potential Complications and Risks Hematoma Hematoma Occurs when blood enters the wound after surgery. Occurs when blood enters the wound after surgery. If excessive, will be drained. If excessive, will be drained. Hip Fracture Hip Fracture Occurs during or after surgery Occurs during or after surgery Caused by: Caused by: Weak bones Weak bones Falling Falling Failure to follow hip precautions Failure to follow hip precautions

16. Potential Complications and Risks Infection Infection About 1% change of infection after surgery About 1% change of infection after surgery Dislocation Dislocation Occurs when the ball of the hip comes out of the socket. Occurs when the ball of the hip comes out of the socket. Caused by: Caused by: size size Blood clots Blood clots

17. Questions?

18. Thank You!