Abstract
Introduction THR is a successful procedure with excellent long term results. With many patients requiring the procedure there is some advantage in rapid recovery and early discharge. This may require a change in the surgical approach and peri-operative management. We report the first series of a new minimally invasive surgical approach for THR.
Methods A two incision approach for THR has been developed after extensive cadaver tests. This consists of an anterior muscle splitting incision to insert the cup and a posterior incision for the stem insertion. The authors have undergone cadaver training and clinical surgery before embarking on clinical trials. Patients included in this study are those people awaiting THR who were selected for a cementless prothesis and who would benefit from early rehabilitation. Patients with previous surgery, hip dysplasia and significant obesity were excluded. An initial study group are presented with an average age of 59, average height 168 cms and average weight 71 kg.
Results Average length of stay was 3.7 days with an average operative time of 90 minutes. Average blood loss 505 mls with an average blood usage of 1.1 units. Early complications include lateral cutaneous nerve of thigh palsy (50% resolution at three months), two stable trochanter fractures, one infection and one anterior dislocation at eight weeks with a ceramic implant.
Conclusions The approach is technically difficult and initially time consuming. It does enable quicker mobilisation and appears to result in less need for analgesia post-operatively. We believe it is important to present the early results so the technique can be discussed and potential problems avoided. A randomised, prospective trial with clinical and RSA follow-up is underway.
The abstracts were prepared by Mr Jerzy Sikorski. Correspondence should be addressed to him at the Australian Orthopaedic Association, Ground Floor, William Bland Centre, 229 Macquarie Street, Sydney NSW 2000, Australia.
None of the authors have received any payment or consideration from any source for the conduct of this study.
