Abstract
Introduction: This minimally invasive (MI) anterior approach has been developed to improve patients’ rehabilitation and long-term function. It is aligned along the interneural plane of Smith-Peterson, with complete preservation of the musculotendinous structures. The femoral neck oeteotomy is performed without dislocation of the joint or resection of the joint capsule. As there is also no additional traction applied to the soft tissues it is one of the most tissue sparing techniques available for THA. The outcome was recorded prospectively and is compared with retrospective data of a conventional lateral approach. No other variables other than the surgical technique were changed for the protocol.
Methods: 55 patients underwent traditional THR (lateral approach) surgery in 2003 and 216 consecutive, non selected patients having an anterior minimal invasive procedure during 2004/05 were followed up for an independent review.
Results: The two groups of patients were comparable in terms of age and BMI. Blood loss dropped by 42%. Hospital stay was reduced by 2.1 days (+/−0.6.) Cup inclination was 45.56 (+/−3.4) in the traditional group and 44.8 (+/−3.7) in the MicroHip group. The dislocation rate was lower in the MicroHip group, being 1/216 compared with 3/55 in the traditional group. Harris Hip score for the MicroHip group was 91.35 at 3 months and 94.43 at 1 year. Average time for return to work was reduced from 8.2 to 2.7 weeks
Discussion: The results show that a truly minimal invasive approach improves the outcome of THR without additional risks. By the use of a treadmill incorporating a dynamic force plate there is even strong evidence that perception and therefore long term results can be improved.
Correspondence should be addressed to Mr Peter Howard, Editorial Secretary, BHS, c/o BOA, The Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE, England.
