When Minimally Invasive is Too Invasive

Orthopedic surgeons at a specialized hip and knee surgery center review three cases of total hip replacement (THR) that had catastrophic results. All three patients were given the THR by a surgeon outside their center. The patients were sent to the hip and knee center by the first surgeon when serious problems developed.

In all three cases the THR was done with a small incision. This method is called minimally invasive. It's a fairly new technique that is still being studied. The goal behind this smaller opening is to reduce blood loss and speed up recovery time. So far studies have not supported these claims.

Each of three cases is reviewed in this report. The authors describe what went wrong and what they did to fix it. In one case the patient died before leaving the recovery room. In a second case the damage couldn't be repaired and the patient had a permanent limp and unstable hip. Only one patient had a successful revision surgery.

These case reports show the need for further study of the minimally invasive THR. This method must be proven safe before it's used with everyone. The authors say problems like this point out the need for surgeons to get special training before trying a new way of operating.