Abstract
The purpose of this study was to evaluate early results of a new, as yet undescribed, minimally invasive, gluteus maximus splitting posterior approach for metal on metal (MOM) hip resurfacing. Surgical approach is described, backed with a video of the procedure. Results of the first 100 cases are presented.
A new, minimally invasive, gluteus maximus splitting approach is described. The single incision approach allowed MOM hip resurfacing to be carried out through an incision ranging 8.25 ± 2.25cm. Release of gluteus maximus insertion to femur is not necessary. Intra-operative fluoroscopy is not necessary. Special acetabular reamer handle and acetabular impactor had to be used for accurate acetabular component placement. Femoral neck targeting device, suitable for minimally invasive surgery was used for accurate placement of femoral neck centring pin. This allowed for accurate placement of femoral component
Results of 100 patients who had undergone MOM hip resurfacing are presented: Average review was 2 years, range 22–46 months. Average age of patient was 57 years; range 55 ± 22 years. Average BMI was 27; range 29.95 ± 11.85. Average blood loss was 270ml; range 450 ± 350ml. Average incision was 8cm; range 8.25 ± 2.25cm. Operation time was no longer than conventional open posterior approach. Early discharge at day 3, post-op was possible and patients were able to walk without aids at 3 weeks, post-op. There were no cases of infection, nerve damage, dislocation or malposition of implant. There was no case of hypertrophic bone formation. There was one fracture neck of femur at 6 weeks post-op.
Minimally invasive hip resurfacing can be carried out successfully using a new gluteus maximus splitting approach with excellent early results and no complications apart from 1% risk of fracture neck of femur.
Correspondence should be addressed to Ms Larissa Welti, Scientific Secretary, EFORT Central Office, Technoparkstrasse 1, CH-8005 Zürich, Switzerland
