In a classic total hip replacement the length of incision is between 8 – 15 cm (3-6 inch), depending on the difficulty of the operation (e.g. revision surgery and obesity of the patient). In the resurfacing procedure the incision is longer (15 – 30 cm/6-12 inch) because of technical-anatomical reasons (saving the femoral head). The length of incision has no influence in the postoperative rehabilitation.

Minimal invasive surgery is not applicable to resurfacing today. Minimal invasive surgery in total hip corresponds with a lot of early complications (17%). The prosthesis placement is often “blind”. A reduction of the incision to “minimal incision” is done by everybody. The 2-incision minimal invasive technique is disregarded by most of the surgeons.

There is a trend toward performing all types of surgery in a less invasive fashion with smaller incisions. Like all new developments, it is somewhat controversial. Minimally invasive techniques are more difficult to master, and every surgeon is not well qualified to attempt this. In the hands of some surgeons, complication rates have been much higher than for traditional surgery. Others have shown excellent results. I have developed minimally invasive techniques for almost all types of primary (not revision) joint replacement that I perform. My complication rates are lower with minimally invasive surgery than those generally published for traditional surgery.

The advantage is less postoperative pain and a better cosmetic result as well as a more rapid healing time. We can now discharge most patients from the hospital within one to two days after surgery using these techniques.