A PROSPECTIVE RANDOMISED PILOT STUDY TO COMPARE EARLY POST-OPERATIVE RECOVERY AFTER CONVENTIONAL VERSUS MINIMAL INCISION POSTERIOR APPROACH FOR TOTAL HIP JOINT REPLACEMENT

Mr Sanjeev Sharma; Mr M S Bhamra

doi:10.1302/0301-620X.88BSUPP_II.0880243b

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A PROSPECTIVE RANDOMISED PILOT STUDY TO COMPARE EARLY POST-OPERATIVE RECOVERY AFTER CONVENTIONAL VERSUS MINIMAL INCISION POSTERIOR APPROACH FOR TOTAL HIP JOINT REPLACEMENT

Mr Sanjeev Sharma
Mr M S Bhamra

A PROSPECTIVE RANDOMISED PILOT STUDY TO COMPARE EARLY POST-OPERATIVE RECOVERY AFTER CONVENTIONAL VERSUS MINIMAL INCISION POSTERIOR APPROACH FOR TOTAL HIP JOINT REPLACEMENT

Sharma MS, Bhamra MMS. A PROSPECTIVE RANDOMISED PILOT STUDY TO COMPARE EARLY POST-OPERATIVE RECOVERY AFTER CONVENTIONAL VERSUS MINIMAL INCISION POSTERIOR APPROACH FOR TOTAL HIP JOINT REPLACEMENT. Orthop Procs. 2006;88-B(SUPP_II):243-243. doi:10.1302/0301-620X.88BSUPP_II.0880243b

Sharma, Mr Sanjeev, and Mr M S Bhamra. “A PROSPECTIVE RANDOMISED PILOT STUDY TO COMPARE EARLY POST-OPERATIVE RECOVERY AFTER CONVENTIONAL VERSUS MINIMAL INCISION POSTERIOR APPROACH FOR TOTAL HIP JOINT REPLACEMENT.” Orthopaedic Proceedings, vol. 88-B, no. SUPP_II, 2006, pp. 243-243., https://doi.org/10.1302/0301-620X.88BSUPP_II.0880243b

Sharma, M. S., & Bhamra, M. M. S. (2006). A PROSPECTIVE RANDOMISED PILOT STUDY TO COMPARE EARLY POST-OPERATIVE RECOVERY AFTER CONVENTIONAL VERSUS MINIMAL INCISION POSTERIOR APPROACH FOR TOTAL HIP JOINT REPLACEMENT. Orthopaedic Proceedings, 88-B(SUPP_II), 243-243. https://doi.org/10.1302/0301-620X.88BSUPP_II.0880243b

Sharma, M. S. and Bhamra, M. M. S. (2006) “A PROSPECTIVE RANDOMISED PILOT STUDY TO COMPARE EARLY POST-OPERATIVE RECOVERY AFTER CONVENTIONAL VERSUS MINIMAL INCISION POSTERIOR APPROACH FOR TOTAL HIP JOINT REPLACEMENT.” Orthopaedic Proceedings, 88-B(SUPP_II), pp. 243-243. Available at: https://doi.org/10.1302/0301-620X.88BSUPP_II.0880243b

Sharma, Mr Sanjeev, and Mr M S Bhamra. “A PROSPECTIVE RANDOMISED PILOT STUDY TO COMPARE EARLY POST-OPERATIVE RECOVERY AFTER CONVENTIONAL VERSUS MINIMAL INCISION POSTERIOR APPROACH FOR TOTAL HIP JOINT REPLACEMENT.” Orthopaedic Proceedings 88-B, no. SUPP_II (2006): 243-243. https://doi.org/10.1302/0301-620X.88BSUPP_II.0880243b

Sharma MS, Bhamra MMS. A PROSPECTIVE RANDOMISED PILOT STUDY TO COMPARE EARLY POST-OPERATIVE RECOVERY AFTER CONVENTIONAL VERSUS MINIMAL INCISION POSTERIOR APPROACH FOR TOTAL HIP JOINT REPLACEMENT. Orthop Procs. 2006 May 1;88-B(SUPP_II):243-243. https://doi.org/10.1302/0301-620X.88BSUPP_II.0880243b

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Abstract

Introduction We conducted a prospective study to compare the early post-operative recovery following the two different incisions.

Materials and Methods 40 patients with BMI ≤ 30 were prospectively randomised (20 patients in each group) by use of envelopes. Conventional incision was 12 cm postero-lateral in all cases and minimal incision was diameter of the femoral head plus 2 cm. The patients, and assessors (physiotherapists and nurses on ward) were unaware of the treatment group.

Results Average age was 66.95 years for MI group and 68.55 for conventional group (p-0.51). Average BMI for MI and conventional group was 26.5 & 24.4 respectively (p-0.029). Average pre-operative Oxford hip score was 41.75 for conventional group and 42.15 for MI group (p-0.87). There was no statistically significant difference as regards the operating times (p-0.207); post-operative day the patients were mobilised with zimmer frame (p-0.71); drop in hemoglobin (p-0.197) and hematocrit (p-0.208) or the need for blood transfusion (p-0.56). However there was a statistically significant difference in the two groups as regards post-operative pain (on a 10 point visual analogue scale) and the number of postoperative days the patient was fit for discharge. Average pain score on day 1 was 4.05 for MI group and 6.25 for conventional group (p-0.0089) with similar difference on day 2 and the day of discharge. Patients in MI group were fit for discharge on an average 1.65 days earlier than those in conventional group (p-0.042). There was no superficial or deep wound infection, dislocation or per-operative fracture in either group. Transient sciatic nerve neuropraxia occurred in one patient in the minimal incision group which recovered within 6 weeks.

Conclusion Minimal incision posterior approach for total hip replacement may be useful in decreasing the post-operative pain and duration of hospital stay. However the incidence of complications is an area of concern and needs to be studied on a larger study group.

Editoral Secretary Mr Peter Howard. Correspondence should be addressed to BHS at the Royal College of Surgeons, 35 - 43 Lincoln’s Inn Fields, London WC2A 3PN.