What is MIS?

Is arthritis-related pain limiting your normal life?

Arthritis is a general term used to describe joint inflammation that leads to pain and a progressive decrease in normal movement. There are more than 100 types of arthritis related diseases and it is estimated that one in every three Americans is affected by arthritis or other chronic joint problem. Osteoarthritis, a degenerative disease related to excessive wear of the articular cartilage, strikes more than 16 million people in the United States. This disease can affect ones ability to perform normal activities, like walking, shopping or even standing up from a chair.

What are your options?

Life-style changes like weight reduction, limiting your physical activities, physical therapy programs, medical treatment (anti-inflammatory medication) or other measures like using a cane are certainly short-term options for arthritic patients. When pain becomes untreatable through conservative therapies, the best long-term solution is often joint replacement surgery.

In recent years, MIS (minimally invasive surgery) for hip and knee replacement has increased in popularity. MIS refers to techniques the surgeon uses during the operation that limits the amount and type of cuts that are performed on the soft tissues (skin, ligaments, muscles, etc.) and in some cases the bone itself. The most outward sign of an MIS procedure compared to a tradition procedure is the length of the incision, which is significantly shorter than traditional incisions. Even though MIS techniques may be used, you must remember that joint replacement is still a major operation where a significant amount of soft tissues and bone must be cut.

Is MIS an option for every patient?

MIS procedures are not suitable for every patient and many considerations have to be taken into account before determining if you are a candidate. Prior to your operation your surgeon will determine if you are a candidate based upon your previous medical history, body weight, extent of damage and other parameters deemed relevant to achieving a successful outcome. Even if you are selected as a candidate for MIS surgery, your surgeon may determine during the operation that an MIS approach is not appropriate for you and may use traditional techniques to ensure that your surgical outcome is not compromised.

You should also be aware that not all minimally invasive techniques are identical. For total hip replacement (THA), there are a number of ways that your surgeon can perform the same procedure. Although in all cases the same general surgical procedures must be performed, that is, the hip socket (acetabulum) and hip ball (femoral neck and head) will be replaced with surgical implants. With knee replacement surgery, your surgeon may choose to replace the entire joint (total knee replacement – TKA) or, if the damage is not extensive, just the part of your knee that is damaged (unicompartmental knee replacement – UKA). Although your surgeon may plan to perform a UKA, it may be necessary to perform a TKA depending on the extent of your knee damage which can only be properly assessed during your operation.

Advantages of MIS surgeries

There are many advantages that MIS procedures for joint replacement surgery offer. As already mentioned, the most outward sign to you will be the incision length. In the case of THA, the incision will be around 3 to 4 inches and with TKA the incision will be 4 to 5 inches. Underneath the incision, there is less trauma to the soft tissues which may lead to less pain and a quicker recovery. Blood loss during the operation may also be reduced as a result of the MIS procedure.

Another advantage of MIS procedures is that your length of hospital stay may be reduced and physical therapy can start earlier. In some cases, patients are even allowed to bear weight on the operated extremity immediately after recovery from anesthesia.