MIS Hip Replacement Technique

MIS Hip Replacement Technique

Hip is a big joint and that is closest to our centre of gravity. Hence a pain free movement of hip is mandatory for a normal active life.

Why do we need MIS in hip? The reason being that hip is covered by thick muscle layer, if we operate by conventional Technique, we have to cut all the muscles; that leads to bleeding during surgery, delayed recovery and post-operative pain.

So when we do it by MIS technique which means that we are not damaging any muscles, we are just going between the muscles. We are avoiding all those disadvantages of open surgery. So MIS hip replacement is very popular these days and specially the technique that we developed at Minomax, has given a fresh lease of life to young people especially of Asian origin because in our Indian and Asian culture sitting on ground, sitting cross-legged and using Indian toilet is mandatory, especially in rural background patients.

How MIS technique Hip Replacement is different?

With MIS Technique we have been able to allow our patients to do all these activities of sitting on the ground. So this is a boon for all those patients who were restricted for life, from sitting on ground after hip replacement. So MIS technique hip replacement is the treatment of choice for any painful condition of the hip joint.

What is MIS technique?

The full form of MIS technique is Minimal invasive surgery. This surgery causes minimal damage to the surrounding tissues while performing the hip replacement.

What is the importance of a surrounding tissue?

A person with a normal hip is allowed to do all activities like sitting on the ground, sitting cross-legged and using Indian toilets but that is not the case with the artificial hip. The reason is that during the replacement of the hip the surrounding structures like muscles, capsule and ligaments are damaged and hence the supporting structures of hip become weak and if the patient attempts all these activities there are high chances that hip will come out of the socket, which is known as dislocation.

With MIS technique, we preserve all the structures, muscles, capsules and ligaments. Also the supporting structures remain intact or almost intact even after the surgery and the replaced hip (artificial hip) behaves just like a normal hip and hence we are able to advise our patients to do everything that they want. The only thing that we don’t allow is regular running, jumping from heights and lifting weights of more than 20 kg. This is because we want the implants to last long. Patients can run or they can lift heavyweight but if they do this their ball bearing surface of the hip will wear and tear very fast and they have to go for a revision surgery at a very early age. So we advise our patients to be mindful of this, otherwise with MIS technique you are as good as any normal young person.

Symptoms and Signs That May Indicate Hip Replacement

Patients with severe hip conditions often experience:

• Persistent hip pain that interferes with daily activities
• Reduced range of motion and difficulty performing routine tasks
• Difficulty walking, standing, or climbing stairs
• Noticeable limb shortening
• A limp or altered gait

Causes and Risk Factors

Conditions that commonly lead to MIS hip replacement include:

• Infections of the hip joint that have damaged the cartilage and bone
• Degenerative joint diseases such as osteoarthritis and rheumatoid arthritis
• Avascular Necrosis (AVN) — loss of blood supply to the femoral head
• Ankylosing spondylitis and other inflammatory conditions causing joint fusion
• Congenital issues such as developmental dysplasia of the hip that result in joint deformity or severe discomfort
• Hip fractures that cannot be repaired by other means

How MIS Hip Replacement is Performed

The MIS hip replacement procedure preserves natural bone anatomy through a few key surgical principles:

• Precise bone preparation: the surgeon creates an exact shape within the femur to accept the prosthetic stem, removing only the bone strictly needed.
• Mini stems: instead of a conventional long stem, a shorter mini stem is used — this requires less penetration into the femur and preserves more of the natural bone, which is especially valuable in younger patients.
• Non-cemented, modern bearing surfaces: the prosthesis uses non-cemented implants with a ceramic-on-poly bearing — designed to integrate with the bone naturally and to wear extremely slowly over time.
• The capsule, muscles, ligaments, and fascia are preserved throughout — the surgeon works between the muscle planes rather than cutting through them.

Recovery and What to Expect

Because the surrounding tissues are preserved, recovery is significantly faster than with open hip replacement. Most patients walk with full weight-bearing from the first day after surgery, with marked pain relief and improved limb-length equality. Regular follow-ups and periodic X-rays are recommended to monitor implant stability and catch any potential issues early.

For patients who require maximum implant-placement precision, robotic-assisted hip replacement can complement the MIS approach. Other MIS variants Dr. Maichand performs include the Direct Anterior Approach (DAA), SuperPATH, and Bikini Incision hip replacement.

Open Technique vs MIS Technique

The conventional open hip replacement typically uses an incision exceeding 10 cm. The larger incision and disruption of surrounding tissue mean more blood loss, a longer hospital stay, a higher likelihood of ICU monitoring, closure with stitches, an extended recovery, and an elevated risk of post-operative dislocation — often leaving patients unable to squat, sit cross-legged, perform Namaz, or use Indian toilets.

The MIS technique works through small incisions, going between the muscles rather than cutting them, and preserves the joint capsule, ligaments, muscles, and fascia. Dr. Ashwani Maichand's method uses an incision of less than 8 cm — a precise, deliberate measure that pushes well below the conventional norm. The hip stays as stable as a normal hip, so patients can comfortably sit on the floor at weddings and social gatherings without the fear of dislocation.

Potential Advantages of MIS

• Less pain
• Less blood loss
• More cosmetic incisions
• Less muscle damage
• Shorter hospital stay
• No stitches

A word of caution: MIS is a demanding technique. In less experienced hands it can carry a higher risk of complications — infection, femur fracture, wound-healing issues, nerve and artery injury, or implant misplacement leading to early wear, dislocation, and loosening. It is important to choose a skilled, experienced surgeon for this procedure.

Frequently Asked Questions