MIS Posterior Approach

Figure 1: Key muscles in MIS Posterior Approach: the minimus, the medius, the piriformis, and the quadratus are all left in place during an MIS posterior approach.

Minimally Invasive Posterior Approach for Total Hip Replacement

The posterior approach to total hip replacement has been the most commonly done, standard hip approach since the beginning of hip replacement. This approach has undergone significant changes as it has evolved into a minimally invasive approach. In the MIS version, most if not all of the important muscle attachments are left in place (Figure 1), and the incision is down-sized (Figure 2).

Figure 2: Incision used in MIS Posterior Approach: most MIS incision are less than four inches in length.

Other investigators have corroborated the results of our study. Patients who have MIS posterior approaches have shorter hospital stays, less postoperative pain, shorter rehabilitation, and smaller incisions.

The primary benefits of the mini-incision procedure were derived in the early perioperative period as no significant clinical differences were observed during subsequent follow-up assessments.

Figure 3: Incision used in Traditional Surgical Approach: Traditional incisions are typically 10 -12 inches long. Also, in this approach, the minimus, the piriformis, and most of the quadratus are released from bone.

Early Pain Relief and Function After Posterior Minimally Invasive and Conventional Total Hip Arthroplasty. A Prospective, Randomized, Blinded Study Lawrence D. Dorr, MD1, Aditya V. Maheshwari, MD1, William T. Long, MD1, Zhinian Wan, MD1 and Leigh Ellen Sirianni, OPA-C1 Jbjs 2007;89:1153-1160