Anterior minimally invasive hip surgery: the One-of-its-Kind surgery in South India

Who doesn’t want to lead a better quality of life, especially after undergoing Hip Surgery, but, is there any such possibility. Of course! There is a real possibility. Have you ever undergone any Hip surgical procedure which is patient friendly, less invasive, less painful, muscles sparing (causing no damage to the muscles) and which provides faster recovery? If not, then read further to know about Anterior Minimally Invasive Surgery (AMIS) and why it is considered as the best.

What makes Anterior Minimally Invasive Hip Surgery (AMIS) the Best?
In this type of surgery, the surgeon approaches the hip joint from anterior (front) side by utilizing the natural muscle plane and gets excellent access to the hip joint without cutting or detaching any muscles. This results in less bleeding, less pain and a very fast recovery for patients.

Is there any evidence that this is a Minimally Invasive Patient friendly approach?
Though this technique is relatively new in India, in Europe it has been in practice since 1930s. Many research studies done so far have shown that (AMIS) patients have shorter recovery time and return to normal function much faster than the traditional approaches.

In another research MRI’s done in patients one year after Total Hip Replacement (AMIS) had shown AMIS as a truly minimally invasive approach as there was no tendon or muscle damage. The patients’ hips looked great as if they had natural hips.

Is AMIS safe? Is there a higher complication rate?
Absolutely no! AMIS is a safe and widely practised procedure in the west. It is safer and less tissue damaging because in a traditional Total Hip Replacement (THR or THA) ,dislocation and leg length inequality are two of the more common complications that surgeons experience.

The surgeons in the traditional approach pre-operatively determine appropriate sizes for prosthetic implants using templates and adjust bone cuts based on static X-ray & do the procedure on the patient positioned in the lateral position without imaging or X-ray guidance.The prosthesis length is adjusted and then implanted based on the soft tissue tension and the stability of the new hip replacement.

Due to this, tightening up of hip joint causes over-lengthening of the leg to gain stability. The end result - weakened, detached tendons & muscles causing Dislocation due to poorly placed components. AMIS approach ensures proper positioning, sizing and placement of the implants as patients lie flat on their back allowing X-rays for each & every step of the procedure.

The end result- a perfect hip replacement consistently, without any single case of hip dislocation in years. Every time a hip replacement is done, the leg length is close to perfect. There are no precautions like bending or hip flexion imposed on patients after the AMIS as the procedure is stable.

Why Doesn’t Every Surgeon Perform AMIS?
This procedure is not every surgeon’s cup of tea. It requires specialization in joint replacement and substantial number of cases to master the technique. A specialist & trained surgeon has many tricks to make the procedure safe & reliable. With my experience & expertise I take great pride in this approach.

This technique is still a new one in India, and it takes years for AMIS to gain popularity in India though it has been practiced in Europe since 1930s. The surgeons who have been doing joint replacements through the traditional approach find it difficult to shift to this technique though AMIS is beneficial for patients.

What are the Risks? What are the Future Risks and Considerations?
The AMIS approach significantly reduces the risks associated with total hip replacement including leg length inequality, dislocation and intra-operative fractures & avoids many potential complications. There are general risks associated with any joint replacement; the most common of which include infection and blood clots. Infection rates for total joints are approximately 1% for primary total joint replacement in healthy individuals.

Very special state-of-the-art operating rooms integrated with modern technology (laminar air flow), world-class ICU’s with the latest monitoring systems, infection control and safety systems focused on ultimate care of the patient reduce the risk of infection.

How long is the Hospital Stay?
Patients often go home the next day after the procedure. Patients with some medical conditions are made to stay in the hospital for a few days. Otherwise, patients are discharged after 1 or 2 days.

By: Dr Nitish Bhan
MBBS, DNB (Ortho), M Ch (Ortho), MNAMS Orthopedic Surgery Advanced Minimal Invasive Direct Anterior Total HipArthoplasty Joint replacement, Sports injuries, Arthroscopy and Complex Periarticular Trauma Surgeon. Continental Hospitals www.continentalhospitals.com 77996616661