One of the main reasons patients opt to forgo hip replacement surgery is the pain associated with recovery. But now Vanderbilt University Medical Center offers a revolutionary minimally-invasive procedure that is changing patients' perceptions, and offering a much faster recovery.

Dr. Andrew Shinar, assistant professor of Orthopedics and Rehabilitation, said the use of the new two incision procedure often yields a quicker recovery time and less pain. Characteristics that are turning first-time hip replacement patient's heads. Typically doctors make a 8 to 12-inch incision for hip replacement, a procedure that calls for muscle to be removed from the bone, causing more pain and longer recovery times. Patients are hospitalized at least four days. In the late 90's doctors began using a 3 to 5-inch incision for the surgery which improved recovery times because the amount of muscle violated was much lower. Hospital stays were lessened to three days. But still the pain persisted.

Recent technology is allowing physicians to perform hip replacement surgery in a manner that causes no muscular damage.

"This new technique changes the way we perform many hip replacements," said Shinar. "We are seeing much quicker recovery times, and more importantly, much less pain. Patients who have had a two-incision replacement on one side and a conventional replacement on the other are definitely noticing the huge difference in the levels of pain."

Using the newest, less-invasive technique, patients are kept overnight and often released the next day.

"We are getting a lot of requests for this procedure because of the distinct advantages to the patients," said Shinar. "If you ask a person why they do not have hip replacement surgery, they will tell you, other than the risks, it is the pain associated with the recovery."

"When a patient is weighing the pain from arthritis and surgery, and decides against having hip replacement, often they are doing more harm to the joint. Patients are sometimes suffering for years when they can have something done to alleviate the problems."

Doctors are now able to use fluoroscopy (X-Rays) in the operating room for a more detailed view of the hip, despite using very small incisions. Two small incisions are made — one near the groin and another in the buttock. This procedure causes less muscle damage because doctors are working between the muscles rather than removing the tissue from the bone.

The new hip replacement surgery is limited to patients who are first-timers, not overweight and have little bone deformity. Patients seeking hip replacement often suffer from osteoarthritis, avascular necrosis and rheumatoid arthritis.

More than 200,000 patients undergo first-time hip replacement procedures in the United States every year.

"As more people undergo this new procedure and the word is spread, more will understand just what an advantage it can be," he said. "The newest surgery can be less damaging and will be more appealing to our patients."

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