Application Of Improved Posterolateral Mini-incision Surgery In Total Hip Arthroplasty

Objective:This topic through effect analysis and comparison of improved posterolateral mini-incision surgery in total hip arthroplasty versus the traditional operation type, is to explore the indications, feasibility and short-term clinical results of improved posterolateral mini-incision surgery in total hip arthroplasty.Methods:Twenty cases of THA were performed through a minimally invasive posterolateral surgical approach(MIS group).Among them, there were 12 males and 8 females, the mean age was 62.8 years and the mean BMI was 23.6kg/m2. They included 17 cases of femoral neck fracture and 3 cases of avascular necrosis of femoral head. For comparison, another 20 cases of THA were performed through a standard posterolateral approach at the same period(standard group). Among them, there were 11 males and 9 females, the mean age was 64.6 years and the mean BMI was 23.8kg/m2. They included 16 cases of femoral neck fracture and 4 of cases avascular necrosis of femoral head. Incision length, operation time, peri-operative blood loss, postoperative lead flow, postoperative VAS pain score, weight-bearing time, postoperative hospitalization, THA Harris score were analysed and compared between the above two groups.Results:There were statistical differences in incision length, postoperative VAS pain score, the loading time, postoperative hospitalization and postoperative 1 month Harris score between the above two groups. But there were no statistical differences in the patient's age, body mass index, preoperative Harris score, operation time, peri-operative blood loss postoperative lead flow and postoperative 3 months,6 months,12 months Harris score between the above two groups.Conclusion:1. MIS-THA has the advantages of little tissue trauma and muscle damage, light postoperative pain, shortened postoperative hospitalization, fast postoperative joint functional recovery, minimal incision, an inconspicuous scar, beautiful appearance, to be easy to be accepted by the patients, etc.2. Under the premise of mastering THA, A mini-incision surgery can be finished without needing special instrument.3. Short-term follow-up, there were no differences in complications and functional activities between MIS group and standard group. 4. Attention should be paid to the indications in choosing a mini-incision surgery.①The patients of obesity and especially developed muscles are unfavorable to choose MIS surgery (BMI<30).②Executing MIS surgery is difficult to the patients of ankylosing spondylitis involving the hip, late osteonecrosis of the femoral head, etc.③The patients of moderate or above acetabular dysplasia, coxa luxation, needing to make special treatment for the acetabular, needing to loose soft tissue are unfavorable to choose MIS surgery.④The doctors should have rich experience of THA.⑤MIS-THA should use the cementless prosthesis.