Introduction to minimally invasive hip replacement and the development of our department

  Hip replacement surgery is now very mature, including materials and surgical techniques have been greatly improved, but traditional surgery has a lot of bleeding, complications and slow recovery after surgery, and the recovery time after surgery is long due to the need to cut off part of the muscles. Due to the long repair time after muscle damage, the follow-up cases are often limited in the long term. In contrast, the rise of minimally invasive hip replacement in recent years has further accelerated the recovery after this surgery. Since no muscles are cut off, the recovery of patients after surgery is greatly accelerated, and they can often move down to the ground on the same day or the next day after surgery, which greatly reduces the pain of patients and basically has no special effect on the function of hip movement after surgery.  However, despite more experience with traditional hip replacement surgery, minimally invasive hip replacement surgery still requires a longer learning curve, and the advantages of surgical bleeding and complications in the early development process are not obvious compared with traditional surgery, requiring a larger amount of surgical learning and experience accumulation to achieve success. The author received funding from the Jiangsu Provincial Health Department in 2013, and gained the essence of minimally invasive surgery during his training in Germany. With the platform of Jiangsu Provincial Joint Disease Center (Nanjing Gulou Hospital is the only designated joint disease center in Jiangsu Province), and with the support of the department head, I performed minimally invasive hip surgery upon my return to China. Since he already had nearly 400 cases of total hip replacement, the minimally invasive surgery went very smoothly. At present, he is the surgeon who has performed the largest number of minimally invasive hip replacement cases in Jiangsu Province and is one of the few surgeons in China who can routinely perform minimally invasive surgical treatment. At present, the complexity of patients undergoing minimally invasive hip replacement (e.g. ankylosing spondylitis, tuberculous hip ankylosis, femoral head necrosis, congenital hip dysplasia, juvenile rheumatoid arthritis, old femoral neck fracture, etc.) is leading in China, and more than 95% of initial total hip replacements are performed with minimally invasive surgery. As of September 2015, nearly 150 minimally invasive hip replacement surgeries have been performed, with incision lengths ranging from 5cm to 10cm, and operating times lower than those of traditional surgery. The complication rate was lower than that of traditional surgery, and the incidence of postoperative thrombosis and bleeding were lower than that of traditional surgery (the relevant articles have been published in 2 papers in domestic core journals). The minimum age of the patients undergoing the surgery is 18 years old and the maximum age is 93 years old, and the recovery after surgery exceeds that of previous surgeries regardless of age.  During the two-year period, the author also had in-depth exchanges and studies with doctors who have rich experience in minimally invasive hip replacement surgery in several medical centers in the United States, Germany, Greece and Austria, including surgical observation and seminars in special conferences. In addition to learning from foreign experience, the author also made various improvements based on the original minimally invasive surgical techniques, including improvement of surgical position, improvement of incision exposure, improvement of surgical pull hook, etc., which made the surgical operation more standardized and precise, and gave lectures and did surgical demonstrations in the departmental artificial joint replacement study classes in 2014 and 2015. He was also invited to give academic reports on minimally invasive hip replacement at the 2014 National Orthopaedic Annual Meeting (COA), the 2014 Jiangsu Provincial Orthopaedic Youth Joint Forum, the 2015 Jiangsu Provincial Orthopaedic Annual Meeting, and the 2015 Chinese Physicians Association Youth Joint Forum, which were highly recognized by domestic counterparts. 2015, he was also invited to participate in the only domestic listed company for artificial joint In 2015, he was invited to the only listed industrial joint company in China to discuss the topic of “minimally invasive hip replacement” (only 6 doctors in China were invited), and gave lectures in many places in the province (Taicang, Kunshan, Jiangyin), and was invited to the Shanghai hip replacement seminar to give lectures on minimally invasive hip replacement and cadaveric operation demonstration. At present, many doctors from other provinces specializing in joint surgery (Hebei, Henan, Ningxia, Hunan, Guangxi, Xinjiang, Zhejiang, Anhui, etc.) have come to learn minimally invasive hip replacement.