Minimally invasive orthopaedic and arthroscopic procedures are used to treat and diagnose injuries and diseases to bones, cartilage, ligaments, muscles and tendons in the ankle, hip, knee, hand, shoulder, elbow or wrist. Most minimally invasive orthopaedic surgeries are done with the use of an arthroscope which is a special thin device designed for viewing and treating problems inside a joint. This arthroscope is equipped with a miniature camera and special tools to perform the minimally invasive surgery. With the arthroscope, the surgeon can cut, shave or remove tissue or bone that are causing the patient discomfort. Not all patients ie:obese, elderly with osteoporosis, are appropriate candidates for less invasive orthopaedic surgeries or procedures. Each patient is evaluated on an individual basis, consult your othopaedic surgeon to see if a less invasive surgery is appropriate for you. Also, minimally invasive orthopaedic surgeries are technically demanding, request a physician who has considerable experience operating in this fashion.
A few medical centers in the US are now employing new high-precision, computer- guided surgical navigation for more accurate less invasive hip and knee procedures. This computer-guided imagery provides the surgeon with a 3D represention of the patient's anatomy and make the procedure safer when the surgeons visibilty is compromised. The University of Pennsylvania Health system is currently employing this technology.
As reported in a news release from Smith & Nephew (1/2/03), The FDA issue approval for it's Achieve brand computer-assisted instruments and software for the accurate placement of the acetabular cup during hip replacement surgery. "While the Achieve technology can be used in a conventional hip surgery, it also enables total hip replacement surgery through a mini-incision, providing a reduction in the soft tissue trauma and long rehabilitation normally associated with the procedure. The Achieve surgical application expands the orthopedists' view of the surgical site, even through mini-incisions, by using specialized technology to track the movement of the instruments and implant relative to the patient's anatomy. The software provides the surgeon with on screen views of both the cup’s abduction and anteversion, thus ensuring the cup’s precise placement."
Smith & Nephew's Achieve computer-assisted surgical applications provide orthopedic surgeons with improved procedural planning, surgical guidance, enhanced visualization and real-time surgical data capture. Achieve applications enable more accurate and less invasive orthopaedic procedures, potentially resulting in improved outcomes and a reduction in rehabilitation time. Smith & Nephew is the first orthopaedic company to receive FDA clearance for fluoroscopy-based, computer-assisted applications in knee, hip and trauma surgery.
A new study out of Imperial College London shows that robot assisted partial knee replacement surgery is "significantly more accurate than conventional surgery." The surgical robotic system used in the study was from the Acrobot Company Ltd, a spin-out from Imperial College London. Read more about this less invasive robotic assisted surgery..
According to the American Association of Hip and Knee Surgeons, patient selection for less invasive surgery is evolving, but some surgeons define the ideal patient as young, thin, healthy, and motivated. Good candidates should have a thorough understanding of the possible advantages and disadvantages of this type of surgery. Is less invasive hip surgery right for you?
Minimally invasive orthopaedic surgery is used for a wide array of applications, such as repair of torn ligaments or cartilage, hip and knee replacement, removal of loose bone or cartilage as well as treatment of some problems associated with arthritis. Minimally invasive hip replacement surgery allows the surgeon to perform the hip replacement through one or two small key hole-like incisions, allowing for a faster recovery, less pain and muscle damage. Read more about less invasive hip replacement surgery.
Less invasive knee replacement is performed through an incision that is a fraction of the size needed for tradtional knee replacement. During less invasive knee replacement, highly skilled surgeons attempt to replace the knee without cutting into or damaging muscles, tendons and other tissues around the diseased knee. Orthopaedic surgeons debate benefits of less invasive knee replacement for patients and challanges for surgeons, read more...
The benefits of minimally invasive orthopaedic surgery include: considerably less post-operative pain, minimal damage to tissue, reduced recovery phase,quicker return to normal daily activities, less scarring, very small "keyhole" incisions or greatly reduced incision size.
Some surgeries can be performed on an outpatient basis, requiring no overnight stay in the hospital. Most minimally invasive orthopaedic procedures can be performed under local or regional anesthesia (blocks), requiring only moderate sedation.This results in less side effects and post-operative pain compared to conventional general anesthesia. Less invasive orthopaedic surgery also has some disadvantages for the patient as well as the surgeon as stated by the AAKHS; smaller field of view, longer procedure time, stretching/ tearing of skin or soft tissues, superficial nerve injury in hip surgery with the anterior incision, fracture of bone during implant insertion, limited implant choices.
Balloon Kyphoplasty is a less invasive treatment option for vertebral compression fractures in which specialized orthopaedic balloons are used to gently lift the broken bone fragments in an attempt to return them to the correct position. Once the bone fragments are in the correct position, the balloon is removed leaving a cavity which is filled with specialized cement to prevent further collapse.
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