Rottinger & Posterior Minimally Invasive Hip Replacement Approaches with Rapid Recovery

Muscle-sparing hip replacement techniques pioneered in Europe and offered in London for faster, safer recovery.

Advanced Hip Surgery with Rapid Recovery in London

At The West London Knee and Hip Clinic, we offer a specialist service for patients seeking rapid, long-lasting relief from hip arthritis and joint pain. Led by consultant orthopaedic surgeon Dr Arjuna Imbuldeniya, we specialise in both the posterior minimally invasive approaches, and the anterior muscle based Rottinger approach — an advanced technique originally developed and popularised by world-famous German colleagues including Professor Robert Hube and Dr Kristian Kley.

We are proud to be among the first clinics in the UK to offer this minimally invasive, muscle-sparing hip replacement procedure, having had the honour of having training with these surgeons, combining surgical precision with a strong focus on rapid recovery and long-term success. Patients are seen at our Mayfair and Chiswick locations, both equipped with state-of-the-art imaging and post-operative care pathways.

What Are Posterior Minimally Invasive Approaches?

The posterior minimally invasive approach is a refined surgical technique that allows for a total hip replacement to be performed using smaller incision and with minimal soft tissue trauma. Unlike traditional hip surgeries that involve cutting through bigger hip muscles and tendons, these approaches work around or between key structures, preserving muscle function and reducing postoperative pain, any smaller tendons that are released are securely repaired prior to wound closure.

Our clinic offers both:

Modern mini posterior approaches: Muscle-preserving adaptations of the traditional technique

Rottinger anterior based rapid recovery approach: A minimally invasive, anterolateral method developed in Munich in 2004, which avoids cutting through any muscles at the front of the hip.

These procedures are carefully chosen and adapted based on your individual anatomy, goals, and lifestyle needs.

The Rottinger Approach: Finally available to patients in London

The Rottinger approach is an innovative muscle-sparing surgical technique pioneered by Dr Michel Rottinger in Munich, Germany. It allows the surgeon to access the hip joint through a small incision without cutting any muscles — working between natural anatomical planes instead between the tensor fascia lata and gluteus medius muscles.

This technique is particularly well-suited to both active patients and those with a raised BMI and offers significant advantages:

Less post operative pain

Shorter operative times

Lower risk of dislocation

Minimal scarring

Faster mobilisation and discharge

At The West London Knee and Hip Clinic, Dr Arjuna Imbuldeniya was among the first orthopaedic surgeons in the UK to train on and offer this approach, having visited the OCM centre of excellence in Munich. He first learned the technique in 2022 bringing this European innovation to his patients in London. The technique has since been recognised for its effectiveness — and was even featured in the Daily Mail for its role in accelerating recovery times and reducing post-operative pain.

What to Expect: The Minimally Invasive Procedure

Minimally invasive hip replacement surgery is typically performed under spinal anaesthetic with light sedation. Dr Imbuldeniya makes a small incision, uses specialised instruments to preserve muscle and tendon integrity, and implants a carefully selected prosthetic joint.

Key features of the procedure:

Use of high-performance implants (ceramic, titanium, or polyethylene)from leading global manufacturers.

No post operative hip precautions so you can move the hip comfortably in any direction you choose and sleep in any position and bend forwards.

Shorter surgery and lower blood loss compared to traditional methods

Faster recovery

Less early post operative pain

No hospital stay beyond 24–48 hours in 95% of cases

Our goal is to allow early mobilisation and limit complications that can arise from prolonged hospital stays or immobilisation in a hospital bed with restriction to certain movements.

Rapid Recovery and Outstanding Outcomes

Our enhanced recovery protocol supports you every step of the way:

Same-day walking with a physiotherapist, including up and down stairs

Return to driving and daily activities within 2–4 weeks

Light exercise usually by 4–6 weeks

Full recovery often achieved by 8-12 weeks

Patients benefit from reduced use of pain medications, fewer complications and a much quicker return to active lifestyles — whether that’s jogging, football, HIT classes, cycling, or more relaxing pursuits such as golf and long walks.

Is a Posterior Minimally Invasive Approach Right for You?

Most patients are suitable as the approach provides the best visualisation and access to the hip joint:

The access is through the gluteus maximus muscle fibres and involves temporarily releasing the small short external muscles obturator internus, gemelli superior and inferior. The piriformis tendon and quadratus femorus are normally preserved. The small tendons are repaired to and reinforced to the bone at the end of the procedure to enable a faster recovery.

We provide a detailed, personalised assessment with imaging and gait analysis where needed, ensuring that you receive the most appropriate, safe and effective surgical option to give you the best outcome.

Why Choose The West London Knee and Hip Clinic?

Dr Imbuldeniya is a double fellowship-trained hip and knee specialist, known for his focus on cutting-edge, minimally invasive treatments that put patient recovery and outcome first.

Having trained in world-class centres across London, Barcelona, and Sydney, Dr Imbuldeniya brings international insight to every case — helping patients select the most appropriate technique, whether that’s the Rottinger approach, a modern mini posterior approach, or another tailored solution.

When it comes to posterior minimally invasive approaches, experience and expertise make all the difference. Patients choose The West London Knee and Hip Clinic for:

A consultant-led service at all stages

Proven results with the Rottinger and modern posterior approaches

Recognition in national media for our role in pioneering minimally invasive hip surgery

Convenient access at our Mayfair and Chiswick locations

An unwavering commitment to innovation, compassion and excellence

We’re proud to help patients regain mobility with confidence — safely, quickly and without compromise.

Book Your Consultation

Interested in learning whether the Rottinger or posterior minimally invasive approach is right for you? Book a consultation with Dr Arjuna Imbuldeniya at one of our London clinics.

Appointments available at:

Lanserhof at The Arts Club in Mayfair

The West London Knee and Hip Clinic in Chiswick

Experience expert care from a recognised leader in minimally invasive hip surgery and take the first step toward a faster, more confident recovery.