The cutting edge of surgery keeps getting smaller. A newer technique that has been gaining momentum, minimally invasive orthopedic surgery (MIS), has doctors and patients talking about the tremendous advances the medical community is making in patient care. With a long-standing commitment to seeking innovative and successful ways to treat their patients, local orthopedic surgeons stand among the medical pioneers who are using this new method that involves operating through a significantly smaller incision.

 

J. Paul Lyet, M.D., Medical Director of the Lancaster General Orthopedic Center and member of Lancaster Orthopedic Group, is one of several local orthopedic surgeons with the training and skills to perform minimally invasive hip replacement surgery. “In some ways, minimally invasive orthopedic surgery is a natural evolution in the course of patient care,” he says. “Over the years, companies have been developing better instrumentation and redesigning prostheses to fit into smaller openings.”

 

More than 168,000 total hip replacements are performed each year in the United States, according to the American Academy of Orthopaedic Surgeons. The first minimal incision hip replacement surgery was performed in Chicago, Ill., in 2001. Since then, minimally invasive hip replacements have been offered at a few medical centers around the country.

 

David Hughes, M.D., of Orthopedic Associates of Lancaster, defines minimally invasive orthopedic surgery as “surgery that produces the least effect on the tissues at the site of the operation…The minimally invasive portion of the operation should not disturb the soft tissues that are important, not just the skin.”

 

During traditional hip replacement surgery, surgeons make an incision up to 12 inches long. This incision cuts through skin and muscles. With the minimally invasive approach, surgeons either make one three-inch incision or two one- to three-inch incisions in the hip/leg area. The result is that, on the outside, patients see a smaller incision. On the inside, patients report feeling less pain which promotes a quicker recovery. Because the major muscles around the hip joint are not being divided, disrupted or cut to the same extent, patients generally recover faster and experience fewer complications during rehabilitation. “They can walk with less pain and usually do not need to use walkers or crutches for as long a period of time. They are usually able to switch to a cane in a few weeks,” Dr. Hughes says.

 

Dr. Lyet says that while recovery can be faster for some people, it is important to keep in mind that hip surgery is still hip surgery and hospitalization, recuperation and physical rehabilitation remain key components of a person’s recovery from such a procedure.

 

Another leading orthopedic surgeon, Thomas Westphal, M.D., of The Westphal Group, has seen the growing popularity of minimally invasive surgery. Although he says it has definite benefits, he agrees that patients need to remember that “it’s still an operation and operations should not be taken lightly.” Dr. Westphal has been using the minimally invasive orthopedic method during all partial knee replacement surgeries for the past 21/2 years. Minimally invasive partial knee replacement surgery involves working with a 3-inch incision while traditional partial knee surgery incisions could be as long as 12 inches. Once inside the knee, surgeons repair the areas damaged from injury, wear, tear and disease. “Minimally invasive surgery involves exposing the joint by going between the muscles and ligaments instead of detaching them,” Dr. Westphal explains.

 

Thomas Renz, D.O., Orthopedic Consultants, says that the idea behind minimally invasive surgery “is to minimize pain and return patients to earlier function.” The potential benefits of minimally invasive orthopedic surgery for both hip replacement and partial knee replacement involve reduced hospital stays (by a day or two), faster recovery time, less pain, less bleeding and a smaller scar. Dr. Renz says that patients receiving minimally invasive partial knee surgery report “a more rapid return to normal function and a more natural feeling knee than a complete or total knee replacement.” While many patients are ideal candidates for minimally invasive partial knee replacement surgery, Dr. Renz says that it is not as suitable for patients who have severely arthritic knees or those with angular deformities.

 

Although minimally invasive surgeries have definite benefits, they still have risks both during and after the procedures—as all the surgeons mentioned. Post-surgery, proper rehabilitation remains a critical part of the patient’s recovery. Besides partial knee replacement and hip replacement surgeries, the minimally invasive approach is also being used in the shoulder for rotator cuff repair, repair of shoulder dislocations, and repair of shoulder fractures.

 

If you have questions about minimally invasive orthopedic surgery and whether or not it is an option for you, consult with your orthopedic surgeon. To find an orthopedic surgeon, try our Find a Doctor feature.