Abstract
Von langenbach first described the posterior approach for total hip arthroplasty in 1874. In recent years advances in operative techniques and instrumentation have allowed surgeon to perform total hip arthroplasty through incision much smaller. The primary goal of any joint replacement is to create a biomechanically arthroplasty with excellent prosthesis position and durable interfaces.
Many american authors propose a definition of minimally invasive hip replacement when the skin incision is between 7–10 cm.
For us, to be mini-invasive means saving non only the skin but saving capsule, muscle and tendons too.
We used a mini-posterolateral approach with a mean length of 7 cm. After incision of the gluteus maximus fascia and fascia lata, the gluteus maximus muscle is blunty split. The short external rotator tendons are located; we proceed to saving the piriformis and quadratus femoris tendons. The gemelli and obturator internus tendons are detached with electrocautery. A capsulotomy is performed. The capsule and obturator tendon are tagged with heavy bone-suture for reattachment. The difficulties of the operation can be reduced if instruments developed for the technique are used.
50 cases of minimal incision posterolateral total hip arthroplasties are performed. More rapid rehabilitation and more prompt return to activities of daily living are also some advantage.
Longer follow-up is required to determine the long-term outcome but, our results encouraged to performed a mini-approach for total hip arthroplasty in patients selection.
Theses abstracts were prepared by Professor Roger Lemaire. Correspondence should be addressed to EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
