This is a topic that has interested me for quite some time now. It seems to me that surgeons are constantly on the look out for ways to do less and less invasive surgery. In fact, I have even read about natural-orifice surgeries being performed on patients who really don’t want scars. But what intrigues me the most is that often times these minimally invasive surgeries (particularly orthopedic ones, it seems) are very difficult for surgeons to perform, and thus increase the risk of surgical error. Do you think that this is indeed the case? Take, for example, a mini-hip replacement. I have read that there is concern about the ultimate alignment of the prosthesis with this technique.
Other minimally invasive surgeries, though, I feel are done because of a greater understanding of human anatomy. The Quad-sparing knee replacement provides an excellent. This procedure works around the quadriceps instead of through it so that the new joint can be better stabilized post-op. I think that it should be reasons like this, not cosmetic ones, that lead surgeons to create new surgical techniques. Thoughts?
I think you have articulated my, and many doctors, concerns very nicely. Ultimately, the goal of orthopedic surgery is not cosmetic.
That said, minimally invasive surgery can be very good at reducing problems associated with the surgery, but it should not cause the surgery to be done in a sub-standard way.
Unfortunately, we can speculate all we want about what we think is better. But only good science can give us a clear answer–and that’s not easy to do. Hip replacement studies generally last for decades, and there is no way to speed that process up. Therefore, it may be years before we know if mini-hip replacement has real advantages or disadvantages when compared to standard hip replacement. We can use preliminary data to help us project findings, but this is not the final word.
My personal worry is when orthopedic companies, and even some doctors, overstate what we know about these new techniques. I’m not at all saying that these surgeries shouldn’t be performed, but patients should understand the potential benefits, and risks, of undergoing a new procedure.
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Dr. Cluett,
This is a topic that has interested me for quite some time now. It seems to me that surgeons are constantly on the look out for ways to do less and less invasive surgery. In fact, I have even read about natural-orifice surgeries being performed on patients who really don’t want scars. But what intrigues me the most is that often times these minimally invasive surgeries (particularly orthopedic ones, it seems) are very difficult for surgeons to perform, and thus increase the risk of surgical error. Do you think that this is indeed the case? Take, for example, a mini-hip replacement. I have read that there is concern about the ultimate alignment of the prosthesis with this technique.
Other minimally invasive surgeries, though, I feel are done because of a greater understanding of human anatomy. The Quad-sparing knee replacement provides an excellent. This procedure works around the quadriceps instead of through it so that the new joint can be better stabilized post-op. I think that it should be reasons like this, not cosmetic ones, that lead surgeons to create new surgical techniques. Thoughts?
Comment by jdm — April 14, 2008 @ 11:59 pm
I think you have articulated my, and many doctors, concerns very nicely. Ultimately, the goal of orthopedic surgery is not cosmetic.
That said, minimally invasive surgery can be very good at reducing problems associated with the surgery, but it should not cause the surgery to be done in a sub-standard way.
Unfortunately, we can speculate all we want about what we think is better. But only good science can give us a clear answer–and that’s not easy to do. Hip replacement studies generally last for decades, and there is no way to speed that process up. Therefore, it may be years before we know if mini-hip replacement has real advantages or disadvantages when compared to standard hip replacement. We can use preliminary data to help us project findings, but this is not the final word.
My personal worry is when orthopedic companies, and even some doctors, overstate what we know about these new techniques. I’m not at all saying that these surgeries shouldn’t be performed, but patients should understand the potential benefits, and risks, of undergoing a new procedure.
Thanks for your comments!
Comment by Jonathan Cluett, MD — April 15, 2008 @ 3:07 pm
What happens if the bone moves slightly after hip replacement surgery? Does it require surgery again to realign it?…about 1/8 of an inch movement.
Comment by Renee Harkey — August 18, 2009 @ 10:15 am