Anterior Minimally Invasive Surgery in Hip Replacement (AMIS)
With the AMIS approach the surgeon DOES NOT CUT MUSCLES, this is fundamental for fast recovery.
Almost all the other approaches must pass through the muscles or cut them.
AMIS is a surgical technique that will improve the quality of your life.
AMIS can provide the following benefits:
No muscles cut;
Shorter stays in the hospital;
Significantly shorter rehabilitation;
Reduction of scar tissues;
Decreased post-operative pain;
Less blood loss;
Reduced risk of dislocation (dislocation is displacement of the femur from the acetabulum);
Faster return to daily activities.
RISKS AND ADVANTAGES:
The Total Hip Arthroplasty will help you to enjoy an active and satisfying life, free from pain that bereaved you of the little pleasures of life.
Your prosthesis will help you to begin again with lots of the activities you have been forced to leave and will give you a greater freedom.
As with any surgical procedure, there are surgical risks. The list of possible complications mentioned below is not intended to intimidate; it should help you to be aware that this operation, under certain circumstances, may sometimes have incidental consequences. These complications, however, are quite infrequent and can be minimised with thorough preparation.
Your surgeon will give you a set of preventive measures to reduce any risk.
Thanks to the AMIS Technique risks are decreased when compared to a standard technique.
The AMIS Technique is an anterior approach that doesn't cut the muscles, then:
the risk of dislocation is reduced
the blood loss is very low, transfusions are exceptional and deep venous thrombosis rare
the infection rate is very low, the incision being on the opposite side of the perineum.
Your general condition (fatigue, anaemia, depression, etc.), ongoing treatments, diseases or deteriorations of some functions will affect the course of the operation and its consequences. The purpose of the pre-operative anaesthesia consultation is to de-tect these factors and considers, if necessary, additional check-ups, precautions, or even contraindicates the operation.
Whatever precautions are taken, accidents may occur. Such incidents however are extremely rare:
the risk is no greater than that of having an accident while driving for a visit to your doctor.
Despite care and prevention, some incidents or problems may occur during surgery, such as:
Injury to adjacent tissues (muscles, tendons).
Injury to blood vessels which may result in haemorrhage.
Injury to nerves, which may result in long-term problems.
Fracture of the femur or acetabulum, with osteoporosis as an aggravating factor.
Despite the pre-operative check-up, unexpected events during the operation may cause your surgeon to change the initially planned procedure and adapt the surgery:
In spite of drainage a hematoma may form. Usually it remains superficial, diffuses under the skin, and creates painless tension in the thigh.
Deep venous thrombosis (DVT) may occur despite prevention with anticoagulants. The DVT may leave lasting painful sequelae and may be accompanied by pulmonary embolism. Walking and continuous anticoagulant treatment after the operation until you stop using crutches is often the best way to avoid these complications.
Infection of the operative site may occur despite precautionary measures. This risk is aggravated by general fatigue or an infectious disease. Poor hygiene cannot be compensated simply by having a shower the day before the operation.
Deep wound infection: severe consequences could persist if the infection cannot be managed by antibiotics.
In rare cases, after the operation, you may perceive your legs having different lengths. If this is due to leg stiffness or preoperative difference, it will disappear in a few days; or it may require correction by a heel pad.
The AMIS Technique reduces the risks specific to the total hip replacement:
with less blood loss, the risk of hematoma and DVT is reduced;
with the incision on the opposite side of the perineum the risk of infection is reduced.
Infection around the prosthesis spreading from a remote infected area:
Dental: Caries are always associated with infection.
Pulmonary: Pneumonia.
Cutaneous: Boil, venous ulcer, putrid wound or ingrown nail.
Urinary: Urinary incontinence, cystitis or prostate enlargement.
Periprosthetic pains:
Periprosthetic pains could persist after the intervention.
Lot of times these pains disappear with the scar formation in a few months.
In comparison with standard techniques, the AMIS approach reduces the post-operative pain and the rehabilitation time.
Premature instability of the prosthesis:
Prostheses have limited lifetimes. Statistically, however, you can expect 15 to 20 years of service.
Early loosening may occur in case of obesity, intense activity, or in some cases for no special reason, requiring premature replacement of the prosthesis.
The Total Hip Replacement is a surgical intervention safe and clinically approved. The main benefits are
Hip articulation pain reduction: the pain will be considerably reduced or even eliminated.
Recovery of the mobility you lost: better mobility with less effort!
Improvement of the quality of your life: you will be able to recover the joy of your everyday acts that you lost because of the reduced mobility and the pain.
Thanks to the AMIS Technique the preservation of the muscles ensures immediate stability of the hip. The risk of dislocation is minimal and the post operative limitation of movements usually prescribed in other techniques is not necessary.
Rehabilitation can be started the day of the operation, standing up and walking with arm-crutches is allowed on the same, or one day after the operation. Depending on the general condition of the patient crutches can be removed generally from the third day. But each case is different: some patient never needs any crutches and some keep the crutches for several weeks.
The preservation of gluteus medius prevents limping.
DRIVING:
In the car, pivot with both legs tight to get in or out of the car.
Thanks to the AMIS Technique the return to daily activities is faster.
Depending on your general condition one should wait approximately 8-10 days before driving.
OUTSIDE:
Go out for a walk every day.
WALKING IS THE BEST REHABILITATION:
Use the crutch in case of need depending on how you feel.
Take the same precautions as above when doing odd jobs or housework.
Care Instructions:
Implant longevity can be affected by accidents. Prevention is the best to avoid early problems.
Infection may spread into the prosthesis from a remote location. Therefore we advise you to take a number of precautions:
Every year, have your teeth checked by a dentist.
See a chiropodist for care and treatment of your feet in case of problems.
Gentlemen, have your prostate checked up every year.
Ladies, re-educate your bladder to avoid urinary incontinence which may result in infection.
Never accept intramuscular injection near the operated zone.
In case of fever, throat inflammation and pulmonary inflammation or similar, tell your doctor about your prosthesis, so that it can be protected by systemic antibiotic therapy, if needed. Prosthesis wear is a normal process, which must be controlled. Osteoporosis may affect the operated hip and increase the risk of fracture and loosening.
