Preliminary Experiences In Mini-incision And Minimally Invasive Surgery For Total Hip Arthroplasty

Objective: To explore the indication, to describe the key of operative technique in detail and to summarize the early results in mini-incision and minimally invasive surgery (MIS) total hip arthroplasty (THA) for hip disorders.Methods : From Mar.2004 to Mar.2005, 43 patients(49hips)were per-formed with MIS THA. The mean age of patients was 53.2years ranging from 22 to 79 years, There were 22males and 21 females. The average body mass index (BMI) was 23.4 ranging from 17.1 to 30.2. Using the modified postero-lateral approach, MIS THA was performed with cementless prostheses. For comparison, 35 patients(43hips) were performed with standard THA at the same period. The age and BMI of patients in patients (43hips) were performed with standard THA at the same period. The age and BMI of patients in both groups were similar, but the pattern of disorders was different. The comparative items included preoperative bleeding, operative time, incisional length, postoperative functional recovery, and prosthetic position.Results: 31 patients(MIS THA) and 25 patients(standard THA) were followed from 6 to 18 months(mean13.1 months). No complications occurred in MIS THA. Dislocation appeared in one patient with standard THA at the two days after operation. The length of incision was 7.5 cm(range,6.0 to 8.5cm) in MIS group and 13.5cm (range,12 to 15 cm ) in standard THA group. The difference was significant statistically (p<0.05) .Perioperative blood loss was (318±223.1) ml in MIS THA and (523±210.7) ml in standard THA respectively. The postoperative drainage was (252±169.1) ml and (507±217.7) ml respectively in two groups(P<0.05). The operation time was similar in two groups. The recovery of function was rapid in MIS THA at the early stage, but the functions of joint were similar in both groups six months after operation. The pros-thetic position was good both in MIS and standard THAConclusion: The MIS THA can be indicated in selected patients with hip disorders. The advantages of MIS THA are less trumatic, less blood loss, good cosmetic incision and rapid recovery of function. The MIS THA can only be used by surgeons rich in expe-rience in THA and in hospitals provided with necessary instruments.