A Surgeon’s Perspective: Minimally Invasive Hip & Knee Surgery

B. Sonny Bal MD, MBA, Associate Professor
Department of Orthopaedic Surgery
University of Missouri Health Sciences Center

Hip and knee replacement using minimally invasive surgery (MIS) methods is of keen interest to surgeons and patients. Improvements in technique and surgical instrumentation allow today’s surgeons to insert prosthetic hip and knee joints using shorter skin cuts with less surgical trauma, resulting in fewer days spent in the hospital. Patient demand and competitive pressures on surgeons have almost guaranteed that MIS techniques are the future. What should you, as a prospective patient, know about MIS hip and knee replacement surgery to make a safe and appropriate choice for yourself?

You should know that MIS hip and knee replacements are still in evolution. Accurate information and data are hard to come by. Patients usually learn about these techniques on promotional web sites, from companies who advertise implants directly to consumers, and from local surgeons claiming to be “the first” to perform a certain operation. In truth, hip and knee replacement, and the surgical techniques associated with them have been around for decades. Today, we have better implants, improved instruments, computer navigation technology, and vastly improved anesthesia techniques that have radically changed joint replacement surgery. But very few, if any, surgeons today can truly claim to be the first to perform a surgical procedure.

And, despite the improvements mentioned above, the risks of surgery remain a reality. MIS hip and knee replacement do not eliminate risk. In fact, surgery with a shorter incision can introduce new risks and complications. Unless the surgeon has particular interest, training, and experience in MIS hip and knee replacement, it is best to stick with traditional techniques, despite the longer recovery time. The key goal that cannot be compromised is the excellent proven outcome of prosthetic hip and knee replacement for the patient. What is the point of minimally invasive surgery if you need another operation soon after the first?

Our goal is to disseminate honest and complete information on the pros and cons of minimally invasive surgery as it relates to hip and knee replacement. In experienced hands, these procedures have superb short term outcomes, with faster recovery, less pain, and shorter down time. But not all surgeons can deliver these results. Research the issue, ask questions, speak with your surgeon, carefully weigh your options, ask more questions, kick the tires, and make a decision. In the years to come, implants, surgeons, and techniques will change ever faster, delivering more benefits, more risk, more promise, and better ultimate outcomes to patients. MIS hip and knee replacement will be with us for a long time. Let us know how we can help you make an informed choice.