Is Minimally Invasive Surgery Better for Joint Replacement?

Alison Bassetto, 52, started golfing when she was 12 and never lost her love for the sport. She competed in college and continued to hit the links throughout the coming decades. As she approached 50, however, Bassetto, of Naperville, Ill., started to experience nagging pain in her left hip that interfered with her game — and her life.

Credit: Adobe Stock

“It wasn’t going away. When I golfed, I couldn’t walk anymore and had to start taking a cart,” she says. “I couldn’t sleep and I couldn’t jog anymore.”

Eventually, she was diagnosed with arthritis in both hips — though her left was worse than her right — and told she’d need a hip replacement. Bassetto was frightened at the idea of surgery.

“I put it off and put it off… but when the pain got to be ridiculous and was impacting my day-to-day life, I knew I had to have it,” she says.

After looking into her options, she had her left hip replaced through minimally invasive surgery in November 2015. A week later, she was back to work. She was back on the golf course the following spring.

According to the Agency for Healthcare Research and Quality, part of the U.S. Department of Health and Human Services, more than 1 million people — most of them 50 and older — will opt for joint replacements each year. While traditional surgery remains the more popular option, minimally invasive techniques are gaining ground with patients seeking faster, less painful recoveries.

“With traditional surgery, we said, ‘soft tissue doesn’t matter and the only thing that really matters is putting bones back together,’” says Dr. Richard Berger, an orthopedic surgeon at Rush University Medical Center in Chicago.

Surgeons made large incisions and cut through muscles, tendons and ligaments as a matter of course to perform joint replacements and other common orthopedic procedures. Over time, however, doctors recognized that these surgical techniques could be improved.

“It turned out that just about all of the pain and dysfunction after surgery was due to the damage we caused during the surgery — and almost none of it was manipulation of the bone and restoring the bone itself,” says Berger. Patients could expect a hospital stay of several days, followed by weeks off work to recover.

In the early 2000s, however, surgeons began to experiment with new techniques and new instruments that allowed them to make smaller incisions, minimize muscular detachment and cut less tissue during procedures.

“When you don’t cut the muscles, ligaments and tendons, a revelation happens,” says Berger. “Patients feel good right away; they get their function back right away; they can go home right away… it hastens the initial recovery and makes physical therapy so much easier because you’re not trying to rehabilitate tissues that you’ve cut in half.”

And minimally invasive surgery can be done on an outpatient basis. Bassetto’s surgery was scheduled at 7:15 in the morning and she was on her way home at 1:30 that afternoon. She was walking with a cane immediately after the surgery and didn’t require any extra help once at home.

However, far more surgeons perform traditional surgery compared to this new method. Berger estimates that minimally invasive techniques are used in about 10 to 15 percent of all joint replacement operations, which are technically more difficult to perform than the traditional method. As more surgeons learn the method and more patients request it, though, Berger says it will continue to grow in popularity.

Bassetto is proof of the difference such a surgery can make. She had logged more than 100 rounds of golf by spring of 2016 and was hitting the ball 10 to 15 yards further than before. She also qualified for the USGA Women’s Mid Amateur tournament, which she had never done before.

She has recommended the surgery to friends facing similar joint issues.

“I know I couldn’t have worked that hard on my game before because I wasn’t physically able to,” she says today. “It’s amazing what an impact the surgery can have on your life.”

Of course, any surgical procedure carries risks. If you need a joint replacement, however, minimally invasive surgery may be a smart option for you.