Abstract
Background: Minimally Invasive Hip Replacement Surgery (MIS) has been promoted by patient choice. Patients request less trauma, smaller scars and shorter hospital stays. MIS has been randomly defined as incision less than 10cm long. Are we achieving the patients goals and if so are we potentially compromising long term results in the process.
Design: Retrospective study
Setting: Acute District General Hospital.
Method: A retrospective study in a district general hospital using a single surgeons patients was performed. 30 patients underwent total hip replacement surgery via a posterior approach. There were 8 uncemented cups and 22 cemented cups and all stems were Exeter, cemented with modern cementation techniques. 15 patients who had incisions less than 10cm (MIS group – average scar length 9.5 cms) were compared with 15 patients with incisions greater than 10cm (Conventional group – average scar length 23 cms).
Data collected included a Visual analogue pain score (VAS), analgesic requirement in the immediate postoperative period, activity score and oxford hip score at a minimum of six months follow up.
Radiographs were assessed independently and blinded for technique, assessing implant position and quality of cementation using Barrack and Charnley and DeLee classifications.
Results: In the immediate postoperative period there was no statistically significant difference in the pain score and the analgesic requirement between the two groups. Neither the oxford hip scores nor the activity scores demonstrated statistically significant difference between the groups at a short term follow up of six months.
There was a statistically significant difference in the scar length between the two groups (p< 0.05).
There were no intra-operative complications in study groups.
Conclusions: Though we accept that this is a small pilot study, we feel that MIS joint replacement can be safely performed and is more pleasing for the patients. There was no difference in analgesic requirements, blood useage or hospital stay. These advancements in surgical technique require constant monitoring to ensure good long term results.
Theses abstracts were prepared by Professor Roger Lemaire. Correspondence should be addressed to EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
