Abstract
Introduction and aim: In order to harness existing surgical skill and expertise of the operator trained in conventional total hip arthroplasty (THA) it would be advantageous to adopt a mini-incision surgery (MIS) THA technique that is similar. It would also make economic sense for MIS THA to be performed using existing conventional instrumentation available in every elective orthopaedic unit. The aim of this retrospective comparative study was to verify safety, efficacy and durability of this MIS THA technique via a modified anterolateral approach developed in our hospital by the senior author. This technique utilises standard instrumentation and does not require the use of an image intensifier.
Materials and Methods: The implants used in the study were the SL-Plus (Plus Endoprothetik AG, CH-Rotkreuz) and the EPF cup (Plus Endoprothetik AG, CH-Rotkreuz). We report on our experience of a consecutive series of 111 patients operated for osteoarthritis of the hip joint.
Results: Fifty-nine patients (53.2%) were implanted using MIS technique; the remainder (52 cases, 46.8%) were operated using conventional THA via traditional anterolateral approach. In patients undergoing MIS technique a skin incision averaging 8 cm (range 7.5 to 9 cm) was made over the greater trochanter with two thirds lying superior to its tip. The surgical procedure lasted forty minutes on average, and no excessive retraction was needed. The small incision can be extended with ease if access proves difficult, but this proved unnecessary in any of our cases.
The mean follow-up for the MIS THA group was 22.9 months compared to 33.1 months for the conventional THA group. All our MIS patients had less postoperative blood loss, needed less post operative painkillers, and mobilised earlier. There was however no significant difference in the duration of postoperative hospital stay between the two patient groups. We have had no incidence of dislocation and continue to use this technique during routine THA.
Discussion and conclusion: A review of the MIS THA literature is provided to compare this technique with those described by other authors. The authors believe this to be a safe, cost effective alternative to MIS THA techniques that require special instrumentation and the use of the image intensifier.
Theses abstracts were prepared by Professor Roger Lemaire. Correspondence should be addressed to EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
