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Dr.
Michael Crovetti practices orthopedic surgery in Henderson and Las Vegas,
Nevada. He is the owner of The Bone and Joint Institute of Southern Nevada.
Dr. Crovetti attended medical school at the University of Medicine and Dentistry
of NJ, completed his residency in Orthopedic Surgery at Ohio University
in Dayton, Ohio and was fellowship trained in Adult Reconstructive Surgery
in Las Vegas, Nevada. It was during his fellowship that Dr. Crovetti began
learning and perfecting his surgical technique. Define what you call a minimal-incision hip replacement. I don’t think minimal-incision is the term I would prefer, but minimally invasive. Minimally invasive should be less invasive. The preservation of the tissues is most important. I also think that efficiency in the OR is important. The combination of efficiency and tissue-preservation makes a hip or knee replacement safer, less painful, and a solution for quicker recovery. When and why did you start performing the mini-incision? During my fellowship in 1999. The advantages, such as a reduced hospital stay and a faster return to an active lifestyle were clear. Plus, less cutting of soft tissue meant less post-operative pain and a drastic reduction of scarring — up to 75%. The mini-incision just made sense. How long did it take you to get comfortable performing the mini-incision? Perhaps 20 cases. Many people think that this is just a marketing ploy. Do you believe there are benefits to the procedure? If so, what are they? The people saying that this is a marketing ploy are giving an excuse not to try it. Again, the benefits are clear and make sense. What are the potential pitfalls of the procedure? The learning curve. Component malposition is probably the greatest concern. This results from the learning curve and feeling that you cannot see the necessary landmarks. What do you think is the difference in what you are doing and the two-incision approach? Predictability. I do the mini-incision or attempt the mini-incision in everyone. The two-incision is not done in everyone and is not predictable. The anterior or lateral approach is performed less commonly than the posterior. I feel the learning curve is steeper in the posterior minimally invasive procedure. What do you believe is the best way of learning your procedure? Cadaveric dissection, physician focus groups (small), visiting professor programs, and finally, continuing the branding to entice physicians to learn new techniques that are better for patients. LINK to Educational Opportunities Any other thoughts? Continue the diligence and this procedure will not only benefit Smith & Nephew but will truly benefit patients. |
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