Minimally Invasive Hip Replacement And Advanced Techniques – What Does This Really Mean For You?

Are you living with daily hip pain and considering a hip replacement? If so, your priority is likely getting back to the activities you love, safely and quickly. Here, internationally-renowned Consultant Orthopaedic Hip Surgeon Mr Jerome Davidson explores how advanced, minimally invasive techniques can help you get your balance and bounce back.

Minimally-invasive hip replacement vs traditional hip replacement 

Traditional hip replacement surgery relies on a larger incision (usually 10 to 12 inches). To access the joint, the surgeon must detach or cut across some of your muscles and tendons. While effective, there is considerably more tissue damage which can mean a longer, more uncomfortable recovery period as those tissues heal. There can also be an increased risk of hip dislocation before all of the supportive tissues around the new hip have healed. 

Minimally invasive hip replacement surgery is performed via a much smaller incisions (usually 3 to 4 inches). Most importantly, it minimises damage to internal soft tissue structures including muscles and tendons. This protects your body’s natural support system, which leads to less trauma, lower risk of blood loss, and a significantly quicker recovery.

The long-term success rates of minimally invasive hip replacement are comparable to that of traditional hip replacement. The benefits of minimally invasive hip replacement are that it involves less trauma to the body, and less impact on your blood vessels and muscles. Recovery tends to be significantly quicker, with lower risk of blood loss. Patients enjoy shorter hospital stays and can get back to their lives more quickly. 

Choice of a skilled surgeon is important and as the NICE guidelines assert, minimally invasive hip replacement requires a surgeon with specialised training. The procedure is frequently more technically demanding than traditional hip replacement. Because the incisions are smaller, in most approaches to minimally invasive hip replacement, visibility is reduced.

However, some surgeons (such as Mr Jerome Davidson of JD Hips), use the STAR approach to minimally invasive hip replacement – a leading-edge technique that offers excellent visibility and minimal postoperative downtime (see below for an explainer).

Traditional hip replacement versus minimally invasive hip replacement

Incision size

• With traditional hip replacement: 10 to 12 inch surgical incisions.
• With minimally invasive STAR approach: 3 to 4 inch surgical incisions. 

Impact on tissues

• With traditional hip replacement: Significant soft tissue dissection and muscle cutting. 
• With minimally invasive STAR approach: Spares the muscles and tendons surrounding the hip joint as much as possible. 

Recovery

• With traditional hip replacement: Demands a longer period for rehab and healing. And patients will often stay in hospital for 2 to 3 days or more.  
• With minimally invasive STAR approach: Shorter stays in hospital – and with the STAR approach there is often only an overnight stay needed. Surgery can be performed with no overnight stay. Recovery significantly quicker. Return to normal life faster. Often walking assisted on the day of surgery.

Long-term outcomes

• With traditional hip replacement: Broadly comparable to minimally invasive hip replacement.  
• With minimally invasive STAR approach: Broadly comparable to traditional hip replacement.

Suitable for

• With traditional hip replacement: Almost every patient irrespective of weight or joint damage.  
• With minimally invasive STAR approach: Suitable for most patients.

What is the STAR approach and why is it a smart option for minimally invasive hip replacement? 

The superior transverse atraumatic reconstruction (STAR) approach is designed to get you back on your feet as soon as possible.

The STAR approach is an advanced technique that accesses the hip through a small, muscle-sparing window at the back of the joint. Because it is designed to cause minimal disruption to your tissues, patients often experience excellent results with minimal postoperative downtime.

Unlike some other minimally invasive hip replacement approaches, STAR offers excellent, unobstructed visibility of the hip joint. And, unlike its predecessor (the minimally invasive direct superior approach), it spares your piriformis muscle (which is key for your balance and stabilisation) as well as your tendons. 

Only a small number of surgeons in the UK are currently able to perform STAR. Mr Jerome Davison is one of them. 

What are the best implant materials for minimally invasive hip replacement? 

Mr Davidson says: “For long-term hip replacement success, implant materials really matter. Our goal is to use premium materials that integrate seamlessly with your natural bone, providing you with lasting stability and movement for years to come. In uncemented hip implants you want the implant to integrate with your natural bone so you can move with good balance and stability. The right implant materials are significantly more wear-resistant and compatible with your body. They are less likely to create bone-destroying debris, infections requiring revision surgery, and problematic immune reactions.”

Mr Davidson uses carefully selected, uncemented hip implant with excellent materials as follows:

The stem and socket material: The stem of a hip implant is the long metal rod that will be placed inside the hollow centre of your thigh bone. The socket is a shell that’s shaped like a cup and acts as a substitute for your own damaged hip socket. For both of these, Mr Davidson prefers to use titanium or titanium alloy, because of their superior compatibility with the body.

The hip implant bearing material: The bearing is the crucial contact surface where the implant ball (which is attached to the end of the metal stem and replaces the top of your thigh bone) and the socket liner glide together. In this way, they imitate the natural hip joint and take your body’s weight. Mr Davidson prefers to use delta ceramic-on-delta ceramic materials for the bearing. This is because ceramic-on-ceramic bearings are highly durable. Research shows they are safe, and long-lasting, giving you the peace of mind that your new hip is built to withstand the demands of your active life – even 20 years post-operation. Studies have also demonstrated that the material is most compatible with the body and less likely to cause immune reactions. He finds these bearings are particularly popular with younger patients that want to push for longevity and maximum wear. 

In some cases dictated by what the patient wants or needs he might pair the delta ceramic head with a highly crosslinked polyethylene liner, which have significantly lower wear rates than other plastics. 

Minimally invasive hip replacement carefully tailored to individual patient need

Every patient is different. Mr Davidson can offer new-generation techniques including robot-assisted surgery and customised implants if a patient’s anatomy demands it. “‘”But it’s not about gimmicks or tech for tech’s sake,”’” he says. “‘”Individual patient need dictates everything.”’”

As a fellowship trained surgeon, Mr Davidson has spent extra time specialising in addition to his orthopaedic training. He has received specialist training from some of the best-renowned surgeons on the globe, at dedicated centres including The Royal National Orthopaedic Hospital (UK) and The Royal Adelaide Hospital (Australia).

Indeed, research shows that hip replacement surgery performed by fellowship trained surgeons results in better outcomes and fewer complications. As one of the UK’s best-known, high-volume, fellowship trained surgeons, Mr Davidson has performed countless successful hip replacements, helping patients get their balance and their bounce back. 

To arrange a consultation or talk through your hip concerns, contact Mr Davidson’s secretary at 020 8168 0111 or simply book a consultation online.