Kingdom Report - Royal National Orthopaedic Hospital
surgical approach for total hip replacement allows faster rehabilitation,
no muscle damage
- By Mr Panos
Consultant Orthopaedic and Sarcoma Surgeon, Honorary Lecturer, Department
of Physics, UCL
Recently there has been an increase
in interest in performing hip replacement surgery by less invasive means,
and by smaller incisions. Some of these so called minimally invasive techniques
however are only reduced skin incision techniques and are associated with
the same muscle and/or tendon injury as �conventional� approaches.
AMIS� (Anterior Minimally Invasive
Surgery) is a surgical technique used in total hip replacement procedures
which follows an inter-muscular and inter-nervous plane to reduce the
risk of injury to muscles, tendons, vessels and nerves. By respecting
the nerves and because no muscles are cut, this aids rapid recovery for
patients following surgery.
What are the advantages?
- DECREASED POST-OPERATIVE
PAIN: In comparison with �conventional� surgical techniques,
the AMIS approach can reduce the post-operative pain as muscles are
- SHORTER REHABILITATION:
Rehabilitation can usually start the day of the operation or the day
after. Standing up and walking with arm crutches can start immediately.
- SHORTER HOSPITAL STAY:
The AMIS� technique usually signifi cantly reduces the duration of hospital
- SMALL SKIN SCAR:
With AMIS�, the skin incision is often shorter than with �conventional�
surgery and therefore scar tissue is reduced.
- FASTER RETURN TO DAILY
- REDUCED RISK OF DISLOCATION:
The preservation of muscles signifi cantly improves the stability ofthe
hip. The risk of dislocation is minimal and the post-operative limitation
of movements, usually prescribed in other techniques, is not necessary.
The risk of dislocation is reduced because the anterior approach is
performed from the front of your body and dislocation is mainly related
to posterior hip structure damage.
- PREVENTION OF LIMPING:
AMIS� is characterised by a surgical technique that protects the various
muscles, blood vessels and nerves encountered during exposure of the
hip joint. Minimizing muscle and nerve damage reduces the chances of
What are the disadvantages?
With an incision in
the front of the thigh, there can be some alteration in the skin sensation
over the front and outer aspect of the thigh. This relates to the anatomy
of the small nerves that provide sensation to the skin and their proximity
to where the surgical incision is made. Over time the area affected by
numbness always reduces signifi cantly.
Does it make a difference
in the long-term?
The most important
factor for the longterm function of a hip replacement is that the hip
implants are inserted correctly so as to reconstruct the anatomy of the
hip. Beyond the proven early benefi cial and faster functional recovery
after an anterior approach hip replacement, we do not know if the approach
itself makes a signifi - cant difference in the longer term.
At the Royal National Orthopaedic
Hospital the AMIS Total Hip replacement is being offered by Mr Panos Gikas,
who has done a postgraduate fellowship at the University Hospital of Geneva
on this approach.
- For more information contact please
contact the Royal National Orthopaedic Hospital Private Patient Unit:
020 8909 5114 firstname.lastname@example.org /