Abstract
Introduction
A new surgical approach for minimally invasive hip resurfacing is described with early results.
Method
A posterior gluteus maximus splitting approach is used. The incision is in line with the fibres of gluteus maximus and is placed 5 cm. distal to the tip of the greater trochanter. Special instruments were necessary to carry out surgery: MIS targeting device for placement of centring pin, MIS retractor system, Chana curved acetabular reamer handle, and curved acetabular impactor.
Results
136 operations were carried out from December 2001 to February 2006. The average age of the patient was 56 years (range 30-78 years). The average body mass index was 32 (range 17.5 to 41.7). The average incision range was 7 cm. (range 6-10 cm.). The average blood loss was 245 ml (range 100-800 ml).
All these patients were sent a postal questionnaire and 91 were returned (70%). Of these 38 were left sided and 53 right sided, 12 bilateral, 47 males and 32 females.
The average review period was 26 months (range 6-56 months). There were 62 conserve implants and 29 ICON implants used.
The median Oxford score was 9.38% and the mean COOP score was 29.8%. There were 2 fracture neck of femurs, one at 6 weeks and the other at 4 weeks post-surgery. Both of these were revised using the same approach with modular head hip replacement system giving a success rate of 97.8% in situ at 26 months (average). There were no cases of infection, nerve palsy, dislocation and hypertrophic bone formation.
Conclusion
Minimally invasive hip replacement can be done safely through a minimally invasive approach using special instruments and the early results are very good.
