Abstract
Introduction: In a prospective clinical study the feasibility of total hip arthroplasty via a minimal invasive single incision anterior approach was analyzed. 100 consecutive patients with no exclusion criteria (52 females, 48 males, mean age 65.6 yrs) were included. 19 patients showed a BMI > 30.
Material and Methods: The patients were placed in a supine position on the OR table. After skin incision the interval between sartorius, tensor fasciae latae, rectus femoris and glutaeus medius/minimus was split to bluntly expose the anterior aspect of the hip joint capsule. No muscle had to be dissected. Following capsular incision the neck was osteotomized in-situ. After reaming a cemented or cement-less cup was inserted. The calcar was elevated with a hook to the level of skin incision. By placing special two-pronged retractor between the inserting abductor tendons and the greater trochanter the broaching of the femoral medullar canal could be easily performed. Followed by implanting a cemented or cement less stem.
Results: The median incision length was 6.75 cm. Median angle of cup inclination was 44.1 and 0 of varus/ valgus position for the stem. Blood loss was significantly reduced. The rehabilitation was fast (mean WOMAC score 90.4 at 6 weeks) and patients showed only little postoperative pain. No dislocations or nerve palsies occurred. The complication rate was low with one fissure of the proximal femur, one perforation of the acetabulum and one deep infection.
Conclusion: The study demonstrated that blood loss, postoperative pain and hospitalization time were reduced with a correct placement of the implants. The rehabilitation was quicker. Therefore we state that the minimal invasive anterior approach is safe and lead to advantages for the patients.
Theses abstracts were prepared by Professor Roger Lemaire. Correspondence should be addressed to EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
