Posterior Hip Replacement

Posterior Hip Replacement

Posterior hip replacement with the “min-posterior” technique is a minimally invasive hip surgery performed to replace the hip joint. With this approach, a smaller incision is used to expose the hip and because most of the muscles and soft tissues surrounding the hip are spared, patients are able to have a quicker return to normal activity.

With the “mini-posterior” hip replacement, the surgeon makes the hip incision at the back of the hip. The incision is placed so the abductor muscles, the major walking muscles, are not cut.  This technique allows for excellent visualization of the hip.

Indications

Hip replacements are indicated in patients with arthritis of the hip joint.

Arthritis is a condition in which the articular cartilage that covers the bony surfaces in the joint is damaged or worn out causing pain and inflammation. Some of the causes of arthritis include:

• Wear and tear
• Congenital or developmental hip diseases
• Inflammatory or auto-immune diseases
• Previous history of hip injury or fracture
• Increased stress on hip because of overuse

Symptoms

Patients with arthritis may have a thinner articular cartilage lining, a narrowed joint space, presence of bone spurs or excessive bone growth around the edges of the hip joint. Because of all these factors, arthritis patients can experience pain, stiffness, and restricted movements.

Diagnosis

Your doctor will diagnose osteoarthritis based on the medical history, physical examination, and X-rays.

X-rays typically show a narrowing of the joint space of the arthritic hip.

Procedure

A “mini-posterior” hip replacement surgery involves the following steps:

• The procedure is performed under anesthesia.
• You will lie on your side on a special operating table that enables the surgeon to perform the surgery from the side of the hip.
• A small incision is made just behind your femur.
• The surgeon spreads the muscles and separates the soft tissues to gain access to the hip joint.
• The thigh bone or femur is dislocated from the hip socket.
• The damaged femoral head is removed.
• The acetabular surface is then cleaned out and prepared for the new acetabular component of the prosthesis.
• Then the new femoral component is inserted into the femur bone and the femoral head component is placed on the stem.
• A liner made up of plastic or metal is placed inside the acetabular component to provide a smooth, gliding surface.
• Once the artificial components are fixed in place, the instruments are withdrawn, soft tissues repaired, and the incisions are closed with sutures and covered with a sterile dressing.

Advantages

Like the direct anterior technique, there are many advantages of the muscle sparing mini-posterior approach compared to traditional techniques and they include:

• High success rate
• Less muscle damage
• Precise placement of implants
• Allows excellent visibility of the joint
• Less postoperative pain
• Minimal soft-tissue trauma
• Smaller incision
• Less scarring
• Minimal blood loss
• Shorter operative time
• Quicker recovery
• Early mobilization
• Quicker return to normal activities
• Short hospital stays

Risks and Complications

All surgeries carry an element of risk whether it is related to the anesthesia or the procedure itself. Risks and complications are rare but can occur. Below is a list of complications that can occur following any hip replacement procedure:

• Dislocation
• Infection at the incision site or in the joint space
• Fracture
• Nerve damage
• Hemarthrosis – excess bleeding into the joint after the surgery.
• Deep vein thrombosis (blood clot)
• Leg length inequality

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