Minimally Invasive Total Joint Replacement – MIS
James Benjamin MD
Minimally invasive surgery (MIS) is a trend in hip and knee replacement that has
become popular in the past five years. As with other forms of surgery, surgeons have
developed techniques that allow joint replacement surgery through smaller incisions,
most commonly 3-4 inches versus more traditional approaches that used incisions of 6-10
inches in length. Despite some publicity to the contrary, joint replacement has not been
“reinvented”. The surgical approaches that are employed are simply modifications of
traditional surgical exposures that have been commonly used since the early part of the
20th century. By exact placement of the skin incision and the use of instruments
specifically designed for use in smaller spaces, the skin incision and deep tissue
dissection can be minimized. Although improvements in the actual joint implants occur
on a regular basis, the implants used in MIS joint replacement are for the most part,
traditional in design.
So what is all of the fuss about? MIS joint replacement, when combined with
modern anesthesia and pain control techniques has led to shorter hospital stays and
quicker return to function. MIS joint replacement has not been proven to eliminate or
even reduce the risks associated with the surgery. Minimally invasive surgery has not
been proven to improve the long-term results of joint replacement. Because it adds an
additional degree of difficulty to the surgery, MIS should be performed by surgeons with
experience in joint replacement and special training in the technique.
The combination of MIS, selected anesthetic techniques and modern methods of
pain control can result in a less painful (not pain free) surgical experience and quicker
post-operative rehabilitation. Modern joint replacement surgery is a reliable and durable
solution to the pain and impairment caused by arthritis regardless of the length of the
incision.