Orthopaedics

A less invasive procedure than traditional surgery is being used with great success for total hip replacements. It’s called Anterior Minimally Invasive Surgery (AMIS) and has the great benefit of faster recovery times. 

Orthopaedic surgeon Dr Jan Joubert of Mediclinic Panorama explains how an AMIS hip replacement works.

When a patient tells you that the surgery they’ve undergone has been life changing it means a job well done. Tim Rands says that within three months of having an AMIS hip replacement, he’d almost forgotten he’d had surgery. ‘I endured sleepless nights for several years where I experienced pain constantly. And now I can walk and even run painlessly,’ says Tim.

Christina Stafford had the AMIS hip replacement procedure in September 2015 and says that by the November she was going to gym, walking, cycling and had regained her energy, fitness and comfort.

Dr Joubert has about 1 800 AMIS total hip replacements under his belt. ‘We’ve fine-tuned the procedure to improve tissue preservation and also made small adjustments to reduce the amount of blood loss,’ he says. ‘We’re now also able to position the implant much more accurately.’

AMIS hip replacement

‘The AMIS technique is performed through an incision of 6-8cm, following the natural tissue planes and thereby preserving all the muscles surrounding the hip joint,’ Dr Joubert explains.

The AMIS technique is universally applicable which means anyone can have it. It’s a great solution for several reasons. The smaller incision limits blood loss and pain, which means a shorter hospital stay and recovery times. The fact that the incision is done at the front of the hip, rather than the side or back as in traditional surgery, means the patient is spared the pain of sitting on the incision site.

Is AMIS cheaper?

Dr Joubert says the procedure can lead to savings on hospital costs of up to 30% and sometimes more. ‘We need less theatre time, and need to perform blood transfusions less frequently,’ he says.

‘The requirements for pain medication are significantly lower, and our patients can go home sooner, with the average discharge time now being just two and a half days.’

All of this results in significant savings.

Are there any downsides to the AMIS technique?

‘No’, says Dr Joubert. ‘There’s a small area of sensory loss on the side of the thigh, as the nerves that supply the skin in this area run close to the incision site, but this is not unqiue to AMIS.

There is, however, one post-operative issue that Dr Joubert is at pains to stress. While the recovery time is significantly shorter because the muscles surrounding the hip joint are entirely preserved, it’s very important for recovering patients not to become too active soon after the operation.

‘It’s still a major operation, and patients must allow time for the proper healing process,’ Dr Joubert cautions.

Doctors 1

Joubert, Jan
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