Minimally Invasive Hip Replacement

For patients who have arthritis of the hip, Dr. Bright frequently recommends stretching, strengthening, and medications. If conservative (non-operative) treatments do not control your pain or improve your function, then minimally invasivehip replacement may be better for you.

New technology in the hip such as ceramic hip replacement and cross-linked polyethylene and minimally invasive surgery have provided his patients with excellent pain relief and physical function. In 2012 when he was President of the Florida Orthopedic Society, he presented research about my technique. Minimally invasive techniques have allowed him to shorten his incision and decrease the pain and blood loss from surgery, and innovations in surgical pain management have also helped his patients recover faster with less discomfort. Dr. Bright's patients are usually up walking an hour or two after the surgery, and usually go home the next day (and in some instances, even the same day!).

Patients who do some physical therapy exercises before their surgery (prehab), usually recover faster.

Here is an article about Prehab:
https://www.heraldtribune.com/news/20140715/w


ANTERIOR VERSUS POSETRIOR APPROACH OF THE HIP:

Many patients ask Dr. Bright in the office about the differences between minimally invasive posterior approach to the hip and the anterior approach and the lateral approach.  There are numerous scientific articles on this subject, but the overall summary is that the chances of a good result are identical between all of these approaches, provided that the surgeon is experienced and the patient is healthy and the hospital is a top orthopedic hospital, all of which would be true if you choose Dr. Bright for your surgery. It is true that there is a chance of complications with hip replacement surgery, and the typical complicatins are different when comparing the posetrior approach to the anterior or lateral approach. The anterior approach has more muscle damage according to blood levels of muscle damage (although doctors who perform it frequently state incorrectly that the opposite is true). There is a higher chance of nerve injury with the anterior approach, but the nerve that is injured (up to 30%, the lateral femoral cutaneous nerve) is a less important nerve and the injury usually resolves and causes pain and numbness on the front of the thigh. The chance of failure of the surgery is higher with the anterior approach (90% of redo hip surgeries are anterior approach), but this is predominantly from physicians who are learning how to do the anterior approach, and with an experienced surgeon then the risk is minimalized. The anterior approach has a lower chance of dislocation, but if the patient is of an average size and a standard hip ball can be used (95% of all patients), then the chacne of dislocation is the same with anterior OR posterior approach. The posterior approach is quicker and has less blood loss. The posterior approach is also extensile, so if anything went wrong during your surgery (or in the future), then the incision can be lengthened and the problem corrected. The anterior approach is NOT extensile, so if something went wrong then an additional posterior incision may be necessary to repair it. Given all of the potential advantages and disadvantages, Dr. Bright continues to utilize the minimally invasive posterior approach.