Abstract
Introduction Smaller skin incisions during a minimally invasive approach to total hip arthroplasty may accelerate rehabilitation and reduce inpatient stay. Cutaneous nerve injury from a standard 20cm lateral approach was compared with a new, oblique minimally invasive 10cm incision.
Method The two surgical approaches were defined on fifteen cadaveric thighs. Cutaneous nerves lying deep to the incisions were dissected out. Projected nerve injury resulting from each approach was recorded.
Results The mean number of nerves divided by a standard approach was 5.0 compared with 4.1 in the minimally invasive approach (mean difference 0.87, 95% confidence interval 0.03 to 1.7, P=0.043). However, the mean number of nerves per cm divided by the standard approach was 0.25 compared with 0.41 by the minimally invasive (mean difference −0.163, 95% confidence interval −0.09 to −0.24, P< 0.001).
Discussion The oblique incision ran perpendicular to the underlying cutaneous nerves; therefore, more cutaneous nerves were divided per cm than a standard approach. A 10cm oblique incision divides as many nerves as a 16cm standard approach.
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.
