“YALE TECHNIQUE”, A MINIMALLY INVASIVE TECHNIQUE FOR THE IMPLANTATION OF HIP ENDOPROSTHESES. PRESENTATION OF THE TECHNIQUE AND CLINICAL RESULTS

Abstract

Different approaches for minimally invasive implantation of hip TEPs are currently the subject of lively discussion. The technique presented here is a tissue-saving procedure, independent of the implants used, and considerably accelerates early patient rehabilitation. The paper describes the double incision version of the Yale method with its special anatomical features, in particular contrast to Berger’s technique (Chicago). It is possible to work under accurate visual guidance in the acetabular and shaft areas without an X-ray intensifier. The structures of the pelvic and trochanteric muscle origins as well as the iliotibial band remain completely intact.

The results of the first implantations (n = 251) show shorter hospitalisation times, the possibility of muscle-compensated pelvic stabilisation on the first postoperative day, complete weight-bearing without crutches, reduced blood loss and the required EC substitution. The Merle d’Aubigne score both immediately after surgery and on completion of the follow-up rehabilitation shows higher values than conventional techniques. Analysis of the VAS shows considerably less postoperative pain than with conventional techniques.

The peri- and postoperative complications are discussed.

In summary, the Yale technique is a tissue-saving approach to the implantation of hip endoprostheses with pronounced advantages in early rehabilitation for the patient in the sense of immediate postoperative weight-bearing and muscular stabilisation of the pelvis and less pain.