Minimally Invasive Hip Replacement Surgery

Traditional hip replacement surgery is done through an incision that is usually about 10 to 12 inches in length. Beneath the incision, the muscle is separated, and the hip joint is exposed. The surgeon then removes the arthritic hip joint and replaces this with a metal and plastic implant. The surgeon performs this surgery by looking directly at the arthritic hip joint and setting the artificial hip implant into place.

Surgeons replacing a hip
Javier Larrea / Getty Images

Minimally Invasive Surgery

Minimally invasive total hip replacement, developed in the 1990s, uses two small incisions, which causes less damage to tendons and muscles than the traditional approach. The surgeon uses X-ray guidance in the operating room to position the artificial hip. The goal is for patients to have shorter hospital stays, quicker rehabilitation, and better results. However, there are still questions as to whether or not this is actually better than the traditional procedure.


Hip replacement surgery generally has a high rate of patient satisfaction. Even so, surgeons are constantly trying to improve hip replacement. The goal of minimally invasive hip replacement is to provide a procedure that involves less pain, less blood loss, and faster rehabilitation, with results that are as good or better than traditional hip replacement. However, there is still disagreement about whether the overall results are better, or even as good, as traditional hip replacement surgery.

Where It Stands

Proponents of the two-incision technique of hip replacement argue that the surgery can be performed with the same technical precision and less postoperative morbidity. Because the surgery is less extensive, the rehabilitation may be faster, the pain may be less, and it is possible that some complications, such as blood loss and hip dislocation, may be less frequent. Patients may also leave the hospital sooner.

However, research over the years has not shown minimally invasive total hip replacement to be better than traditional surgery in the long term. Some studies have found higher rates of long-term complications in people treated with minimally invasive surgery.

Patients may be attracted to the idea of having a smaller scar and leaving the hospital a little earlier, but these are not the most important goals of hip replacement surgery. Also, not all patients are good candidates for this two-incision technique. Be sure to discuss the pros and cons with your medical team.

2 Sources
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  1. American Academy of Orthopaedic Surgeons. Minimally invasive total hip replacement.

  2. Brismar BH, Hallert O, Tedhamre A, Lindgren JU. Early gain in pain reduction and hip function, but more complications following the direct anterior minimally invasive approach for total hip arthroplasty: a randomized trial of 100 patients with 5 years of follow up. Acta Orthop. 2018;89(5):484-489. doi:10.1080/17453674.2018.1504505

By Jonathan Cluett, MD
Jonathan Cluett, MD, is board-certified in orthopedic surgery. He served as assistant team physician to Chivas USA (Major League Soccer) and the United States men's and women's national soccer teams.