Minimally invasive surgery for orthopaedic conditions allows a more rapid return to normal function by reducing the damage to the body during surgery. Dr Liew is a strong advocate for truly minimally invasive approaches for both hip and knee replacements.
What is Minimally Invasive Surgery?
Minimally invasive surgery for orthopaedic conditions allows a more rapid return to normal function, reducing the load on the body after surgery. In general, minimally invasive surgery is more technically demanding but can result in a more rapid rehabilitation. The concept of minimally invasive techniques for hip and knee surgery is not new — for decades, orthopaedic surgeons have been looking for ways to improve outcomes by reducing the areas that need to heal after surgery.
What Truly Minimally Invasive Means
For surgery to be truly minimally invasive, it is what occurs under the skin that is more important than the size of the skin incision. Muscles and nerves should be respected — using tissue planes that go between areas supplied by different nerves — and bleeding should be reduced.
A decrease in blood loss may also reduce infection risk, as there is less haematoma under the skin to act as a nidus for infection. Orthopaedic surgeons can utilise a multitude of approaches to the hip and knee, and often the one performed most frequently yields the best outcomes.
For Hip Replacements — The Direct Anterior Approach
In total hip replacements, the Direct Anterior Approach uses a muscle plane that goes between muscles of the hip, avoiding cutting them from bone. This is a truly internervous and intermuscular approach. The recovery and rehabilitation after a total hip replacement via the Direct Anterior Approach is in general, fast.
Dr Liew performs the DAA for all primary total hip replacements, having trained with world leaders including Dr Frederic Laude in France.
For Knee Replacements — Patient Specific Technology
For total knee replacements, Dr Liew performs a medial parapatellar approach with a lateral skin incision to improve post-operative kneeling. The VMO (Vastus Medialis) remains attached to the quadriceps mechanism, preserving quadriceps function.
Patient Specific Technology is used for all knee replacements, allowing pre-operative planning of every bone cut without the need for rods to be inserted into the femur or tibia during surgery — further reducing soft tissue trauma.
Dr Liew's Commitment to Minimally Invasive Surgery
Dr Chien-Wen Liew gives regular patient and doctor talks on performing the Direct Anterior Approach for total hip replacements and Patient Specific Technology for Total Knee Replacements. His commitment to minimally invasive principles underpins every surgical decision.
To learn more or arrange a consultation, contact Orthopaedics 360 on (08) 7077 0158.
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