DePuy Orthopaedics a Johnson & Johnson company, has introduced refined soft-tissue retractors for minimally invasive hip replacement surgery.

With refined soft-tissue retractors, surgeons can make a three-to-four inch incision and still have a good view of the operative area. The surgery uses a technique DePuy Orthopaedics has been developing since 1994.

"An important advantage of the mini-incision technique is that it is not as disruptive to the strong muscles of the leg as conventional surgery," said Dr. Wayne Goldstein, President of the Illinois Bone and Joint Institute who practices at Rush North Shore Hospital outside Chicago. "We believe that mini-incision total hip replacements result in less pain and quicker recovery for our patients," Dr. Goldstein said.

The advantage of the small incision instruments is that they expand the universe of potential patients for whom this may not have otherwise been an option.

The surgical technique -- published by DePuy and developed with a panel of renowned surgeons -- contains instructions to surgeons about how to perform the procedure and can, in fact, accommodate any length of incision.

If required for an optimal patient outcome, this technique also accommodates a traditional ten- to twelve-inch incision during surgery. A larger incision may be required if the surgeon is unable to clearly see the area where an implant must be inserted. The patient's anatomy may also result in the need for a larger incision.

The most important criteria in technique determination is expected patient outcome. For example, Dr. Goldstein says that trying to achieve the goal of shorter hospital stays, while seemingly desirable, may not always be the best option for every patient and individual situation. Additionally, the surgeon must choose between techniques that employ radiation to visualize the surgical area, and those, like the technique developed by DePuy, which eliminate the need for radiation through the use of refined tools.