The Revolution in Orthopaedic Surgery
Orthopaedic surgery has undergone a transformation in the past two decades. What once required large incisions, weeks in hospital, and months of recovery can now often be achieved through small keyhole incisions, with patients walking the same day and home within 48 hours.
At Nestiva, over 70% of our elective orthopaedic procedures are now performed using minimally invasive techniques.
What is Minimally Invasive Orthopaedic Surgery?
Minimally invasive surgery (MIS) uses small incisions — typically 2–4 cm compared to 15–30 cm in traditional open surgery — through which specialised instruments and a camera are inserted. The surgeon operates while viewing a high-definition video feed, often magnified to reveal structures not visible to the naked eye.
Key Techniques We Use
Arthroscopy — A camera (arthroscope) is inserted into a joint through a small incision. Used for knee, shoulder, hip, ankle, and wrist procedures including:
- ACL and meniscus repair
- Rotator cuff repair
- Hip labral repair
- Removal of loose bodies
Minimally Invasive Total Knee Replacement (MIS-TKR) — Through a 10–12 cm incision (vs. 20–30 cm traditional), we perform complete knee replacement with significantly less muscle disruption.
Minimally Invasive Hip Replacement (MIS-THR) — Single or two-incision approaches that preserve the hip capsule and surrounding muscles, reducing dislocation risk and allowing same-day mobilisation.
Robotic-Assisted Joint Replacement — Our da Vinci and MAKO robotic systems provide:
- Pre-operative CT-based 3D planning
- Real-time bone cutting accuracy to within 1 mm
- Optimal implant positioning for each patient's anatomy
Endoscopic Spine Surgery — Disc herniations, spinal stenosis, and foraminal narrowing treated through 7–8 mm incisions under endoscopic visualisation.
Benefits Compared to Traditional Open Surgery
| Traditional Open | Minimally Invasive | |
|---|---|---|
| Incision length | 20–30 cm | 3–12 cm |
| Hospital stay | 5–7 days | 1–2 days |
| Blood loss | 500–1000 mL | 100–250 mL |
| Return to work | 8–12 weeks | 3–6 weeks |
| Post-op pain | Significant | Moderate/Mild |
| Complication rate | Higher | Lower |
Are You a Candidate?
Most patients with the following conditions are candidates for minimally invasive approaches:
Knee: Osteoarthritis, ACL tears, meniscus tears, patellar instability
Hip: Osteoarthritis, labral tears, femoroacetabular impingement, avascular necrosis
Spine: Disc herniation, spinal stenosis, spondylolisthesis, compression fractures
Shoulder: Rotator cuff tears, shoulder impingement, SLAP tears, instability
Patients with severe deformity, revision surgery, or significant bone loss may still require traditional open approaches — our team will assess your suitability.
What to Expect: The Nestiva Patient Journey
Pre-operative
- Comprehensive assessment including X-ray, MRI, and CT planning
- Blood tests and anaesthetic review
- Physiotherapy pre-habilitation to strengthen surrounding muscles
- Medical optimisation (blood sugar, blood pressure, anticoagulation management)
Day of Surgery
- Admission 2 hours before surgery
- Spinal or general anaesthesia (most joint replacements use spinal)
- Surgery: 60–90 minutes for knee/hip replacement
- Post-anaesthesia recovery: 1–2 hours
Recovery
- Day 1: Walking with a frame, physiotherapy begins
- Day 2–3: Discharge home with exercise programme
- Week 2–4: Driving, light activities
- Week 6–12: Return to sport and full activities
Our Enhanced Recovery After Surgery (ERAS) Programme
Nestiva's ERAS protocol systematically reduces complications and shortens recovery:
- Pre-operative carbohydrate loading rather than prolonged fasting
- Multimodal pain management combining regional nerve blocks, anti-inflammatory drugs, and targeted analgesics — minimising opioid use
- Early mobilisation: Patients are standing within 4 hours of surgery
- Wound infiltration with local anaesthetic for additional pain control
- Nutritional support and hydration optimisation
Choosing the Right Surgeon
Ask your orthopaedic surgeon:
- How many of these procedures have you performed?
- Do you use robotic assistance? What is your alignment accuracy?
- What is your hospital's infection rate and revision rate?
- Will I participate in an ERAS programme?
At Nestiva, our orthopaedic team performs over 2,500 procedures annually with a 97.8% success rate and revision rate below 1%.
