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Which is more invasive—mini versus standard incisions in total hip arthroplasty?

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Abstract

In this study, interleukin-6 (IL-6), C-reactive protein (CRP), and haemoglobin levels were evaluated to compare the degree of surgical invasion between mini and standard incisions in total hip arthroplasty (THA). Sixty-two patients admitted for primary cementless THA were enrolled in this randomised study. The patients were allocated to have surgery through either a mini incision of <10 cm or a standard incision of 15 cm. In each group, inflammatory responses were evaluated by IL-6, CRP, and haemoglobin levels before operation and one day after operation. Significant differences were not found in IL-6, CRP, and haemoglobin levels between both groups. At six months after surgery, there were no significant differences in postoperative Harris hip scores or radiographic evaluations between both groups. In conclusion, a 5.0 cm difference in the skin incision to the hip joint seemed to have no influence on the degree of surgical invasion during THA.

Résumé

Afin de mesurer l’importance de l’agression chirurgicale tissulaire dans les prothèses totales de hanche, incision standard, versus mini-invasifs, les niveaux d’Interleukin 6 (IL-6) de protéine C-réactive (CRP) et d’hémoglobine doivent être appréciés. 62 patients devant bénéficier d’une prothèse totale de hanche primaire sans ciment ont été enrôlés dans cette étude randomisée. Ces patients devaient bénéficier soit d’une mini-incision inférieure à 10 cm, soit d’une incision standard supérieure à 15 cm. Chaque groupe a été évalué avec ces différents facteurs biologiques avant l’intervention et un jour après intervention. Il n’a été trouvé aucune différence significative dans les deux groupes avec ces différents marqueurs Inteleukin, CRP et hémoglobine. Six mois après la chirurgie pas de différence significative non plus au niveau des scores de Harris ou au niveau de l’évaluation radiographique. En conclusion, la différence d’incision cutanée de 5 cm ne semble pas avoir d’influence sur l’importance des lésions des parties molles au cours d’une prothèse totale de hanche.

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References

  1. Baumann H, Gauldie J (1990) Regulation of hepatic acute phase plasma protein genes by hepatocyte stimulating factors and other mediators of inflammation. Mol Biol Med 7:147–159

    PubMed  CAS  Google Scholar 

  2. Bilgen O, Atici T, Durak K, Karaeminogullari O, Bilgen MS (2001) C-reactive protein and erythrocyte sedimentation rates after total hip and total knee arthroplasty. J Int Med Res 29:7–12

    PubMed  CAS  Google Scholar 

  3. Brady OH, Garbuz DS, Masri BA, Duncan CP (2000) The reliability and validity of the Vancouver classification of femoral fractures after hip replacement. J Arthroplasty 15:59–62

    Article  PubMed  CAS  Google Scholar 

  4. Delgado S, Lacy AM, Filella X, Castells A, Garcia-Valdecasas JC, Pique JM, Momblan D, Visa J (2001) Acute phase response in laparoscopic and open colectomy in colon cancer: randomized study. Dis Colon Rectum 44:638–646

    Article  PubMed  CAS  Google Scholar 

  5. Di Cesare PE, Chang E, Preston CF, Liu CJ (2005) Serum interleukin-6 as a marker of periprosthetic infection following total hip and knee arthroplasty. J Bone Joint Surg [Am] 87:1921–1927

    Article  Google Scholar 

  6. DiGioia AM 3rd, Plakseychuk AY, Levision TJ, Jaramaz B (2003) Mini-incision technique for total hip arthroplasty with navigation. J Arthroplasty 18:123–128

    Article  PubMed  Google Scholar 

  7. Frndak PA, Mallory TH, Lombardi AV Jr (1993) Translateral surgical approach to the hip. The abductor muscle “split”. Clin Orthop 295:135–141

    PubMed  Google Scholar 

  8. Fukushima R, Kawamura YJ, Saito H, Saito Y, Hashiguchi Y, Sawada T, Muto T (1996) Interleukin-6 and stress hormone responses after uncomplicated gasless laparoscopic-assisted and open sigmoid colectomy. Dis Colon Rectum 39:S29–S34

    Article  PubMed  CAS  Google Scholar 

  9. Goldstein WM, Branson JJ, Berland KA, Gordon AC (2003) Minimal-incision total hip arthroplasty. J Bone Joint Surg [Am] 85:33–38

    Google Scholar 

  10. Kehlet H (1999) Surgical stress response: does endoscopic surgery confer an advantage? World J Surg 23:801–807

    Article  PubMed  CAS  Google Scholar 

  11. Kennon RE, Keggi JM, Wetmore RS, Zatorski LE, Huo MH, Keggi KJ (2003) Total hip arthroplasty through a minimally invasive anterior surgical approach. J Bone Joint Surg [Am] 85:39–48

    Google Scholar 

  12. Kishimoto T (1989) The biology of interleukin-6. Blood 74:1–10

    PubMed  CAS  Google Scholar 

  13. Ogonda L, Wilson R, Archbold P, Lawlor M, Humphreys P, O’Brien S, Beverland D (2005) A minimal-incision technique in total hip arthroplasty dose not improve early postoperative outcomes. J Bone Joint Surg [Am] 87:701–710

    Article  Google Scholar 

  14. Ohzato H, Yoshizaki K, Nishimoto N, Ogata A, Tagoh H, Monden M, Gotoh M, Kishimoto T, Mori T (1992) Interleukin-6 as a new indicator of inflammatory status: detection of serum levels of interleukin-6 and C-reactive protein after surgery. Surgery 111:201–209

    PubMed  CAS  Google Scholar 

  15. Sculco TP, Jordan LC, Walter WL (2004) Minimally invasive total hip arthroplasty: the Hospital for Special Surgery experience. Orthop Clin North Am 35:137–142

    Article  PubMed  Google Scholar 

  16. Suzuki K, Kawachi S, Sakai H, Nanke H, Morita S (2004) Mini-incision total hip arthroplasty: a quantitative assessment of laboratory data and clinical outcomes. J Orthop Sci 9:571–575

    Article  PubMed  Google Scholar 

  17. Targarona EM, Gracia E, Garriga J, Martinez-Bru C, Cortes M, Boluda R, Lerma L, Trias M (2002) Prospective randomized trial comparing conventional laparoscopic colectomy with hand-assisted laparoscopic colectomy: applicability, immediate clinical outcome, inflammatory response, and cost. Surg Endosc 16:234–239

    Article  PubMed  CAS  Google Scholar 

  18. Waldman BJ (2003) Advancements in minimally invasive total hip arthroplasty. Orthopedics 26:833–836

    Google Scholar 

  19. Wentz JF, Gurkan I, Jibodh SR (2002) Mini-incision total hip arthroplasty: a comparative assessment of perioperative outcomes. Orthopedics 25:1031–1043

    Google Scholar 

  20. White J, Kelly M, Dunsmuir R (1998) C-reactive protein level after total hip and total knee replacement. J Bone Joint Surg [Br] 85:909–911

    Article  Google Scholar 

  21. Wirtz DC, Heller KD, Miltner O, Zilkens KW, Wolff JM (2000) Interleukin-6: a potential inflammatory marker after total joint replacement. Int Orthop 24:194–196

    Article  PubMed  CAS  Google Scholar 

  22. Woolson ST, Mow CS, Syquia JF, Lannin JV, Schurman DJ (2004) Comparison of primary total hip replacements performed with a standard incision or a mini-incision. J Bone Joint Surg [Am] 86:1353–1358

    Google Scholar 

  23. Wright JM, Crockett HC, Sculco TP (2001) Mini-incision for total hip arthroplasty. Orthopedics 7:18–20

    Google Scholar 

  24. Yamaguchi T, Naito M, Asayama I, Kambe T, Fujisawa M, Ishiko T (2003) The effect of posterolateral reconstruction on range of motion and muscle strength in total hip arthroplasty. J Arthroplasty 18:347–351

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Fukuoka University School of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan

    T. Shitama, T. Kiyama, M. Naito, K. Shiramizu & G. Huang

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  1. T. Shitama
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  2. T. Kiyama
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  3. M. Naito
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  4. K. Shiramizu
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  5. G. Huang
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Correspondence to T. Shitama.

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Shitama, T., Kiyama, T., Naito, M. et al. Which is more invasive—mini versus standard incisions in total hip arthroplasty?. International Orthopaedics (SICOT) 33, 1543–1547 (2009). https://doi.org/10.1007/s00264-008-0708-7

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  • DOI: https://doi.org/10.1007/s00264-008-0708-7

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