Abstract
The authors modified the original minimally invasive (MI) two-incision total hip arthroplasty (THA) technique and used large-diameter (32mm, 36mm) ceramic-on-ceramic articulation. One hundred and seventy patients that underwent unilateral MI two-incision THA retrospectively reviewed, and surgical morbidities, functional recoveries, radiological implantation properties, and complications were assessed. The mean follow-up was 30.2 months (range, 24-42 months) and mean patient age was 50.4 years (range, 22-83 years). In the lateral position, an anterolateral approach between the gluteus medius and tensor fascia lata and a posterior approach between the piriformis and gluteus medius was used. Mean operation time was 71.2 minutes (range, 48-91 minutes). Mean Harris hip score improved from 41.8 (range, 10-59) to 96.1 (range, 73-100) at last follow-up, and mean WOMAC score from 66.2 (range, 49-96) to 26.9 (range, 24-39). The mean lateral opening angle of the acetabular component was 38.2° (range, 32.1°-47.7°) and the mean stem position was valgus 1.9° (range, varus 2.3° to valgus 4.8°). One patient suffered an intraoperative femur fracture and another underwent revision surgery due to stem subsidence. No patient experienced dislocation. Our data suggest the this modified technique is safe and reproducible in terms of achieving proper implant positioning and early functional recovery. In particular, the complication rates encountered, especially the dislocation rate, were low.
