Minimally invasive hip replacement:

The complete patient guide

Everything about meaning, minimally invasive surgical approaches (AMIS/ALMIS/DAA), benefits, risks, short stem prosthesis & rehabilitation

What does "minimally invasive" mean in hip replacement?

Today, the use of a hip replacement is not just about alleviating pain and restoring mobility – rather, tissue preservation, rapid mobilization, and shorter rehabilitation times are the focus. A minimally invasive hip operation uses the latest approaches, through which muscles and tendons are largely not severed. This technique is increasingly used in the specialist world for coxarthrosis, femoral head necrosis, and other degenerative hip joint changes .

An artificial hip joint – in technical terms, a hip prosthesis – completely replaces the damaged joint with implants made of blunt metal, ceramic, or plastic. The lateral or anterior minimally invasive approach enables this with smaller incisions and a more gentle procedure than the classic large approaches.

The most important minimally invasive approaches (AMIS, ALMIS, DAA)

AMIS – Anterior Minimally Invasive Surgery

AMIS is the anterior minimally invasive approach to the hip joint.
The approach is between muscles and nerves, without cutting through them.
Advantages include less blood loss, faster functional recovery, and shorter hospitalization.
Studies show accelerated rehabilitation without significant long-term disadvantages when performed by experienced surgeons.
The AMIS approach is particularly well-established in patients with coxarthrosis.

LEARN MORE: AMIS APPROACH - THE NEW STANDARD IN HIP SURGERY

ALMIS – Anterolateral Minimally Invasive Technique

ALMIS is an anterolateral approach between muscles and tendons.
Here, too, muscles are not cut through, but rather gently held aside, facilitating postoperative pain and rehabilitation.
Compared to traditional approaches, ALMIS shows similar benefits to AMIS: less postoperative pain and faster mobilization.

LEARN MORE: ALMIS APPROACH AND SHORT STEM PROSTHESIS

DAA - Direct Anterior Approach

DAA generally refers to the direct anterior approach to the hip joint.
The AMIS technique is based on DAA, but uses additional technical aids for a particularly gentle procedure.

Benefits of Minimally Invasive Hip Replacement

Tissue Preservation & Reduced Pain

Minimally invasive approaches preserve muscles, tendons, and nerves, reducing postoperative pain and enabling earlier mobility.

Faster Rehabilitation and Shorter Hospital Stay

Many patients can walk again in the first few days after surgery - some even on the day of surgery. This shortens the hospital stay and accelerates the return to daily life.

Smaller Scars and Aesthetic Benefits

Less invasive access usually means a smaller incision, which is also cosmetically advantageous.

Reduced risk of dislocation and functional disorders

Through muscle-sparing techniques, the risk of dislocation of the new joint can be reduced, and the function of the joint remains more stable.

LEARN MORE: COMPARISON OF MINIMALLY INVASIVE APPROACHES AND TRADITIONAL APPROACHES TO THE HIP

Risks and limitations of minimally invasive techniques

Complications

As with any surgery, risks can occur - including:

Infections
Thrombosis
Nerve damage (e.g. lateral femoral cutaneous nerve)
Wound healing disorders

These risks may be slightly higher with the learning curve of less experienced surgeons – therefore, surgical experience is crucial.

Limited visibility and technical requirements

Minimally invasive approaches require specialized instrumentation and high surgical expertise, as the operative field of view is more limited than with traditional approaches. Solid experience in endoprosthetics is therefore a prerequisite.

Short-stem prosthesis & minimally invasive approaches

A short-stem prosthesis means that the shaft in the femur is significantly shorter than in classical prosthesis types. These shafts can be combined with minimally invasive approaches in many cases – especially when bone-sparing intentions are desired.

The benefits are potentially:

Preservation of more bone for possible future revision surgeries
Less operative trauma to the femur
Faster functional deployment

LEARN MORE: EVERYTHING ABOUT SHORT-STEM PROSTHESIS

Rehabilitation & everyday life after minimally invasive hip prosthesis

Immediately after surgery

Mobilization on the day of surgery
Pain management and physiotherapy

First weeks

Increase in walking distances
Stair climbing under guidance
Balance & muscle building training

Months later

Gradual training of sports & everyday activities
Goal: Normal gait, safe stair navigation, driving a car

LEARN MORE: EFFECT OF ALMIS APPROACH ON REHABILITATION

For whom is a minimally invasive hip prosthesis suitable?

This approach is ideal for patients with:

Coxarthrosis with standardized anatomy
Good muscular starting situation
Desire for rapid rehabilitation

Not always suitable is the minimally invasive approach for:

Severely altered bone conditions due to previous operations
Very pronounced anatomical deformity
Acute infections or tumor diseases

LEARN MORE: IMPLANT SELECTION SHORT STEM PROSTHESIS AT THE HIP

Why experience matters: Prof. Kutzner & the Endoprotheticum

For minimally invasive hip operations – especially for demanding short stem procedures and complex cases – surgical experience at the highest level is crucial. At the Endoprotheticum Rhein-Main Prof. Dr. Karl Philipp Kutzner regularly operates minimally invasively, specializing in modern hip endoprosthetics with AMIS/ALMIS/DAA approaches and short stem prostheses. His expertise means:

High surgical safety
Focus on functional result
Individual, patient-oriented therapy planning

This combination of experience, expertise, and patient-centered care makes him one of the leading hip surgeons.

LEARN MORE: TREATMENT CONCEPT AT ENDOPROTHETICUM

Frequently Asked Questions (FAQ)

What is the difference between AMIS and ALMIS?
AMIS is an anterior minimally invasive approach, ALMIS an anterolateral; both spare muscles and enable faster rehabilitation.

Is minimally invasive always better than classical surgical methods?
Not always – in cases of malalignment or previous interventions, a classical approach may be more sensible. Experience and indication are crucial.

How large is the scar with minimally invasive procedures?
The skin incisions are usually 8–12 cm long, significantly smaller than with classical procedures.

LEARN MORE: FREQUENTLY ASKED QUESTIONS ABOUT SHORT STEM PROSTHESIS

Conclusion: Minimally invasive hip prosthesis makes sense and is forward-looking

Minimally invasive hip arthroplasty via AMIS, ALMIS or DAA approaches is now an established and effective option for many patients with hip problems. The benefits lie in faster rehabilitation, less pain and a tissue-sparing surgery. However, it is crucial to have a professionally competent execution by experienced specialists like Prof. Dr. Karl Philipp Kutzner at Endoprotheticum.