Reduced postoperative pain in total hip arthroplasty after minimal-invasive anterior approach
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The development of minimal-incision techniques for total hip replacement with preservation of soft tissue is generally associated with faster rehabilitation, reduction of postoperative pain and increased patient comfort. The aim of this study was to compare a minimal-incision anterior approach with a transgluteal lateral technique for hip replacement surgery with respect to postoperative pain, consumption of rescue medication, length of hospital stay and time to reach a defined range of motion.
In this retrospective cohort study we investigated 100 patients with a minimal-incision anterior approach (group I) and 100 patients with a transgluteal lateral approach (group II) retrospectively undergoing unilateral hip replacement. The study variables were pain at rest and during physiotherapy, amount of rescue medication, the time to reach a defined flexion and time in hospital.
The patients of group I consumed less rescue medication (19.6 ± 6.9 mg vs. 23.6 ± 11.3 mg; p = 0.005) and experienced less pain on the day of surgery (1.3 ± 1 vs. 2.3 ± 1.3, p = 0.0001) and the first postoperative day (0.41 ± 0.8 vs. 0.66 ± 1.1, p = 0.036). The time to reach the defined range of motion (6.4 ± 2 days vs. 7.4 ± 2.1 days; p = 0.001) and the length of hospital stay were shorter (10.2 ± 1.9 days vs. 13.4 ± 1.6 days; p = 0.0001) for group I. However, pain during physiotherapy was higher on the third and sixth through ninth days after surgery in comparison to group II (p = 0.001–0.013).
The implantation of a hip prosthesis through a minimal-incision anterior approach is successful in reducing postoperative pain and consumption of pain medication. Time to recovery and length of hospital stay are also influenced positively. Pain increases during physiotherapy, and may be mitigated by adopting limited weight bearing during the early postoperative period.
KeywordsPostoperative Pain Pain Medication Anterior Approach Full Weight Bearing Postoperative Pain Level
Conflict of interest
The authors report no conflict of interest.
- 3.Berger RA (2003) Total hip arthroplasty using the minimally invasive two-incision approach. Clin Orthop Relat Res 417:232–241Google Scholar
- 4.Bernasek TL, Lee WS, Lee HJ, Lee JS, Kim KH, Yang JJ (2010) Minimally invasive primary THA: anterolateral intermuscular approach versus lateral transmuscular approach. Arch Orthop Trauma Surg 130:1349–1354Google Scholar
- 12.Lawlor M, Humphreys P, Morrow E, Ogonda L, Bennett D, Elliott D et al (2005) Comparison of early postoperative functional levels following total hip replacement using minimally invasive versus standard incisions. A prospective randomized blinded trial. Clin Rehabil 19:465–474PubMedCrossRefGoogle Scholar
- 17.Murphy SB, Tannast M (2006) Conventional vs minimally invasive total hip arthroplasty. A prospective study of rehabilitation and complications. Orthopade 35(7):761–764, 766–768Google Scholar
- 21.Pospischill M, Kranzl A, Attwenger B, Knahr K (2010) Minimally invasive compared with traditional transgluteal approach for total hip arthroplasty: a comparative gait analysis. J Bone Joint Surg Am 92:328–337Google Scholar