A COMPARATIVE COHORT STUDY TO EVALUATE TWO-INCISION VERSUS SINGLE-INCISION MINIMALLY INVASIVE HIP ARTHROPLASTY: ASSESSMENT OF EARLY COMPLICATION RATE AND HEALTH CARE RESOURCE UTILIZATION

Abstract

We compare two applications of minimally invasive hip arthroplasty (MISTHA) with regards to early complication rate and consumption of health care resources. Complications are associated with both manifestations of MIS surgical technique. Two- incision MIS THA is associated with fewer days in hospital in comparison with one incision MIS THA, however requires a greater amount of operating room resources. This paper is among the first to compare two- incision with one incision MISTHA. Two- incision MISTHA may benefit efforts to reduce health resource utilization associated with hip arthroplasty procedures providing that operating room resource consumption and complication rates are not excessive.

A comparative cohort study to evaluate two-incision versus single-incision minimally invasive hip arthroplasty: assessment of early complication rate and health care resource utilization

To evaluate and compare two applications of minimally invasive hip arthroplasty (MISTHA) with regards to early complication rate and consumption of health care resources

One hundred and sixty-five patients received MISTHA from 2002–2004 at a tertiary referral hospital. Patients received two incision (sixty-six patients) or one incision surgery (ninety-nine patients) which was performed according to standard technique. T-test, chi square, fisher’s exact test were used to compare cohorts of MISTHA patients with regards to early complications and consumption of health care resources while in hospital.

At baseline the two cohorts were not different with regards to age, gender, comorbid status, BMI, and pre-operative WOMAC, Oxford-12, SF-12 (p> .05). Major and minor complication rates were similar in the two cohorts (p> .05). Utilization of operating room resources was greater with the two incision group (mean twentyfive minutes more OR time) however length of stay (mean two days less in hospital) and post-operative analgesic use was significantly reduced (p< .05). Complications and operating room resource consumption were highest early in the surgeons’ experience with these procedures.

Complications are associated with both manifestations of MIS surgical technique. Two- incision MISTHA is associated with fewer days in hospital, however requires a greater amount of operating room resources.

This paper is among the first to compare two- incision with one incision MISTHA. Two- incision MISTHA may benefit efforts to reduce health resource utilization associated with hip arthroplasty procedures providing that operating room resource consumption and complication rates are not excessive.