Smaller Incision, Faster Recovery Good News for Tucson Area Hip Replacement Patients.

Thirty million people in the United States suffer from osteoarthritis, which causes deterioration of the cartilage in the joint, allowing bone to rub against bone. That number is expected to increase as the Baby Boomers age. Hip replacement surgery has taken a leap forward with the advantage of new “minimally invasive surgery” techniques, allowing the same high quality and clinically proven hip implant to be inserted through a 2 _ to 3 _ -inch incision, compared to the standard 10-12 inches. Significant potential patient benefits of the technique include:

• Smaller scar – cosmetically pleasing, less trauma, faster healing
• Shorter hospital stay - reduced to 2-3 days versus 3-4 days
• Faster rehabilitation – Patients may return to their normal activities within 3-4 weeks versus the 3-4 month recovery period that is common for a traditional hip surgery.

Surgeons at Tucson Orthopaedic Institute have been trained in the clinically-proven Minimally Invasive Solutions™ (MIS™) Mini Incision hip procedure developed by Zimmer and are pleased with the patient results in the first, post-operative, six months. They are the only surgeons in Southern Arizona trained in the Zimmer MIS™ Mini-Incision hip surgery.

“It’s a big improvement in patient care,” says Jay A. Katz, M.D., who has seen patients walk the same day and some patients go home the next, “but it’s a whole new skill set for doctors.” Technically this procedure is very challenging. Surgeons must be thoroughly trained to do this correctly.”

“Minimally invasive surgery has been around for a while -- what makes MIS™ ‘new’ are the tools that allow us to more precisely do the work with less trauma to the patient,” says Russell G. Cohen, M.D. It isn’t just the length of the incision that is different. Standard hip replacement involves cutting muscle, while in the MIS™, retractors are used to pull the muscles away from the bone. This means the patient will feel less pain and heal more quickly.

The MIS™ procedure takes somewhat longer than the standard even though it is less invasive. Melvin D. Roberts. M.D., who coordinates the surgeons’ continuing education program, explains “Placing a joint is a delicate matter that requires precision.” The surgeons are looking now at a greatly enhanced x-ray camera, the Navigator™, to aid in positioning of the artificial joint.

“We expect patients will be very interested in this procedure,” says Katz. Interest will also come from insurance companies who will see the cost-savings.

“It is incumbent upon us to show some restraint,” Scott V. Slagis, M.D. cautions, “but the results so far make us hopeful for continued good outcomes, resulting in less pain and shorter hospital stays.”

The doctors are monitoring outcomes in anticipation of an overall reduction in surgical complications. So far they remain about the same as in standard procedures, says Slagis, although “we believe these will be reduced in time.”

“’New’ is not always better,” adds Slagis. Tucson Orthopaedic’s surgeons predict a high percentage of hip replacement candidates will be appropriate for the procedure. Patients have to be highly motivated to try a new procedure, even when it is well beyond the experimental stage. Physicians will look at many health factors. Surprisingly, age is not an issue in the MIS ™ Mini-Incision hip replacement surgery. In general, patients may be candidates as long as they are in good general health, of normal weight and have good bone quality. The best candidates for MIS™ are those eager to get back to an active life without pain.

"We want to let people know this is available, and that they are welcome to come in and get a personal assessment and recommendation on the best procedure for their specific needs," John A. Maltry, M.D. explains, adding that one of the primary jobs of a good surgeon is to select the best surgery for each person.

The Institute’s surgeons record their observations and patient progress in every case for the data bank at the institute. Tucson Orthopaedic Research Center is charged with providing feedback to the medical team to continually improve procedures. The information from the MIS™ cases also goes to the Zimmer research and development facility in Warsaw, Indiana, where surgical devices have been manufactured since 1927. The Institute is currently working on other more refined MIS™ procedures for hip replacement and new MIS™ knee replacement procedures which look very promising.

Am I a candidate for the Mini-incision hip replacement procedure?

KUAT-TV News Story with Jay A. Katz, M.D.

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