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Posterior single-incision approach to minimally invasive total hip arthroplasty

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Abstract

Enhanced surgical techniques and instrumentation enable surgeons to perform total hip arthroplasties through minimally invasive approaches. Using incisions typically less than 10 cm in length, surgeons can achieve adequate visualization of the surgical site while minimizing trauma to deep soft tissues. Associated reductions in morbidity should allow for improved rehabilitation and recovery. Although these techniques have been met with some controversy, a number of recent studies appear to attest to their safety and efficacy. Many of these studies have concentrated on a posterior single-incision technique for total hip arthroplasty. Favorable results for such outcomes as operative times, complication rates, pain, functional recovery, and blood loss have been reported, and patient satisfaction has been high. If surgeons and their patients are to achieve maximum benefit from minimally invasive total hip arthroplasties, it will be necessary to design effective educational tools that address the learning curve associated with these approaches.

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References

  1. Archibeck MJ, White RE Jr (2004) Learning curve for the two-incision total hip replacement. Clin Orthop Relat Res 429:232–238

    Article  PubMed  Google Scholar 

  2. Asayama I, Kinsey TL, Mahoney OM (2003) The effect of incision size on clinical outcomes and recovery after total hip arthroplasty with the anterolateral approach. Presented at the 13th Annual Meeting of the AAHKS. Dallas, Texas

  3. Bal BS, Haltom D, Aleto T, Barrett M (2005) Early complications of primary total hip replacement performed with a two-incision minimally invasive technique. J Bone Joint Surg Am 87(11):2432–2438

    Article  PubMed  Google Scholar 

  4. Berger RA (2003) Total hip arthroplasty using the minimally invasive two-incision approach. Clin Orthop Relat Res 417:232–241

    PubMed  Google Scholar 

  5. Berger RA (2004) Mini-incision total hip replacement using an anterolateral approach: technique and results. Orthop Clin North Am 35(2):143–151

    Article  PubMed  Google Scholar 

  6. Berger RA, Jacobs JJ, Meneghini RM, Della Valle C, Paprosky W, Rosenberg AG (2004) Rapid rehabilitation and recovery with minimally invasive total hip arthroplasty. Clin Orthop Relat Res 429:239–247

    Article  PubMed  Google Scholar 

  7. Bertin KC, Rottinger H (2004) Anterolateral mini-incision hip replacement surgery: a modified Watson-Jones approach. Clin Orthop Relat Res 429:248–255

    Article  PubMed  Google Scholar 

  8. Chimento GF, Pavone V, Sharrock N, Kahn B, Cahill J, Sculco TP (2005) Minimally invasive total hip arthroplasty: a prospective randomized study. J Arthroplasty 20(2):139–144

    Article  PubMed  Google Scholar 

  9. de Beer JD, Petruccelli D, Zalzal P, Winemaker MJ (2004) Single-incision, minimally invasive total hip arthroplasty: length doesn’t matter. J Arthroplasty 19(8):945–950

    PubMed  Google Scholar 

  10. DiGioia AM 3rd, Plakseychuk AY, Levison TJ, Jaramaz B (2003) Mini-incision technique for total hip arthroplasty with navigation. J Arthroplasty 18(2):123–128

    Article  PubMed  Google Scholar 

  11. Goldstein WM, Branson JJ, Berland KA, Gordon AC (2003) Minimal-incision total hip arthroplasty. J Bone Joint Surg Am 85-A(Suppl 4):33–38

    PubMed  Google Scholar 

  12. Hardinge K (1982) The direct lateral approach to the hip. J Bone Joint Surg Br 64(1):17–19

    PubMed  CAS  Google Scholar 

  13. Howell JR, Masri BA, Duncan CP (2004) Minimally invasive versus standard incision anterolateral hip replacement: a comparative study. Orthop Clin North Am 35(2):153–162

    Article  PubMed  Google Scholar 

  14. Hungerford DS (2000) Surgical approach in THA: the direct lateral approach is more practical and appealing. Orthopedics 23(5):422

    PubMed  CAS  Google Scholar 

  15. Inaba Y, Dorr LD, Wan Z, Sirianni L, Boutary M (2005) Operative and patient care techniques for posterior mini-incision total hip arthroplasty. Clin Orthop Relat Res 441:104–114

    Article  PubMed  Google Scholar 

  16. Irving JF (2004) Direct two-incision total hip replacement without fluoroscopy. Orthop Clin North Am 35(2):173–181

    Article  PubMed  Google Scholar 

  17. Judet J, Judet H (1985) Anterior approach in total hip arthroplasty. Presse Med 14(18):1031–1033

    PubMed  CAS  Google Scholar 

  18. 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-A(Suppl 4):39–48

    PubMed  Google Scholar 

  19. Kreder HJ, Deyo RA, Koepsell T, Swiontkowski MF (1997) Relationship between the volume of total hip replacements performed by providers and the rates of postoperative complications in the state of Washington. J Bone Joint Surg Am 79(4):485–494

    PubMed  CAS  Google Scholar 

  20. Light TR, Keggi KJ (1980) Anterior approach to hip arthroplasty. Clin Orthop Relat Res 152:255–260

    PubMed  Google Scholar 

  21. Matta JM, Shahrdar C, Ferguson T (2005) Single-incision anterior approach for total hip arthroplasty on an orthopaedic table. Clin Orthop Relat Res 441:115–124

    Article  PubMed  Google Scholar 

  22. Moore AT (1957) The self-locking metal hip prosthesis. J Bone Joint Surg Am 39-A(4):811–827

    PubMed  CAS  Google Scholar 

  23. Mow CS, Woolson ST, Ngarmukos SG, Park EH, Lorenz HP (2005) Comparison of scars from total hip replacements done with a standard or a mini-incision. Clin Orthop Relat Res 441:80–85

    Article  PubMed  Google Scholar 

  24. Munin MC, Rudy TE, Glynn NW, Crossett LS, Rubash HE (1998) Early inpatient rehabilitation after elective hip and knee arthroplasty. JAMA 279(11):847–852

    Article  PubMed  CAS  Google Scholar 

  25. O’Brien DA, Rorabeck CH (2005) The mini-incision direct lateral approach in primary total hip arthroplasty. Clin Orthop Relat Res 441:99–103

    Article  PubMed  Google Scholar 

  26. Ogonda L, Wilson R, Archbold P et al (2005) A minimal-incision technique in total hip arthroplasty does not improve early postoperative outcomes. A prospective, randomized, controlled trial. J Bone Joint Surg Am 87(4):701–710

    Article  PubMed  Google Scholar 

  27. Pagnano MW, Leone J, Lewallen DG, Hanssen AD (2005) Two-incision THA had modest outcomes and some substantial complications. Clin Orthop Relat Res 441:86–90

    Article  PubMed  Google Scholar 

  28. Sculco TP, Jordan LC (2004) The mini-incision approach to total hip arthroplasty. Instr Course Lect 53:141–147

    PubMed  Google Scholar 

  29. Sculco TP, Jordan LC, Walter WL (2004) Minimally invasive total hip arthroplasty: the Hospital for Special Surgery experience. Orthop Clin North Am 35(2):137–142

    Article  PubMed  Google Scholar 

  30. Siguier T, Siguier M, Brumpt B (2004) Mini-incision anterior approach does not increase dislocation rate: a study of 1,037 total hip replacements. Clin Orthop Relat Res 426:164–173

    Article  PubMed  Google Scholar 

  31. Smith-Petersen MN (1949) Approach to and exposure of the hip joint for mold arthroplasty. J Bone Joint Surg Am 31-A:40

    Google Scholar 

  32. Swanson TV (2005) Early results of 1000 consecutive, posterior, single-incision minimally invasive surgery total hip arthroplasties. J Arthroplasty 20(7 Suppl 3):26–32

    Article  PubMed  Google Scholar 

  33. Swanson TV, Ballard JC (2004) The Capsular Noose: a new technique to reduce dislocation after posterior, single-incision MIS THA. Presented at the 14th Annual Meeting of the AAHKS. Dallas, Texas

  34. Waldman BJ (2002) Minimally invasive total hip replacement and perioperative management: early experience. J South Orthop Assoc 11(4):213–217

    PubMed  Google Scholar 

  35. Waldman BJ (2003) Advancements in minimally invasive total hip arthroplasty. Orthopedics 26(8 Suppl):s833–s836

    PubMed  Google Scholar 

  36. Watson-Jones R (1936) Fractures of the neck of the femur. Br J Surg 23:787–808

    Article  Google Scholar 

  37. Wenz JF, Gurkan I, Jibodh SR (2002) Mini-incision total hip arthroplasty: a comparative assessment of perioperative outcomes. Orthopedics 25(10):1031–1043

    PubMed  Google Scholar 

  38. 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-A(7):1353–1358

    PubMed  Google Scholar 

  39. Wright JM, Crockett HC, Delgado S, Lyman S, Madsen M, Sculco TP (2004) Mini-incision for total hip arthroplasty: a prospective, controlled investigation with 5-year follow-up evaluation. J Arthroplasty 19(5):538–545

    Article  PubMed  Google Scholar 

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Conflicts of interest statement

The author was a consultant for Plus Orthopedics and Smith & Nephew Orthopaedics during the study.

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  1. Desert Orthopaedic Center, 2800 E. Desert Inn Road, Suite 100, Las Vegas, NV, 89121, USA

    T. V. Swanson

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  1. T. V. Swanson
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Correspondence to T. V. Swanson.

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Swanson, T.V. Posterior single-incision approach to minimally invasive total hip arthroplasty. International Orthopaedics (SICO 31 (Suppl 1), 1–5 (2007). https://doi.org/10.1007/s00264-007-0436-4

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  • DOI: https://doi.org/10.1007/s00264-007-0436-4

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