There is a trend toward performing all types of surgery in a less invasive fashion with smaller incisions. Like all new developments , it is somewhat controversial. Minimally invasive techniques are more difficult to master , and every surgeon is not well qualified to attempt this. In the hands of some surgeons , complication rates have been much higher than for traditional surgery. Others have shown excellent results. I have developed minimally invasive techniques for almost all types of primary (not revision) joint replacement that I perform. My complication rates are lower with minimally invasive surgery than those generally published for traditional surgery. For detailed risk quotes , for my procedures , please see Forms #10 , #11 , and #12. When I perform minimally invasive surgery , I use "extensile" incisions that can at anytime be increased in length if more access is required in a particular case. I do not hesitate to use this option when necessary. I believe inserting the implants properly is a much higher priority than a small incision or a quicker healing time. However , large incisions are only rarely necessary unless the patient is very obese or muscular.