MINIMAL INVASIVE ANTEROLATERAL TOTAL HIP ARTHROPLASTY

Abstract

Objectives: Total hip arthroplasty by minimal invasive anterolateral exposure is a technique which causes minimal damage on skin, muscles and bone and lead to early recovery. Current study compared the clinical and radiological results of total hip arthroplaties performed with two different exposure- minimal invasive anterolateral (MIA) and standard anterolateral exposure (SA).

Methods: Several parameters of total hip arthroplasty patients managed with two different exposures between 2005 and 2008 were evaluated retrospectively from medical records. First group was consisted of total hip arthroplasty patients managed with SA exposure. 26 hip of 25 patients were operated in this cohort. Mean age, follow up and body mass index was 57±12.45 year, 25.23±8.71 months and 32.52±5.77 respectively. Second group was consisted of total hip arthroplasty patients managed with MIA exposure.15 patients were operated in this cohort. Mean age, follow up and body mass index was 68.93±5.51year, 26.07±7.21 months and 28.69±2.72 respectively. Intraoperative, postoperative, total blood loss, operation time, blood transfusions, length of hospital stay were evaluated. Preoperative; postoperative 1,6,12,24 th hours VAS scores and Harris Hip Score (HHS) in preoperative; postoperative 1,6,12 th months and last controls were evaluated. Femoral component position (varus or valgus), inclination of acetabular component and signs of loosening were evaluated from the last follow up radiographies.

Results: Intraoperative, postoperative, total blood loss, blood transfusions, length of hospital stay were significantly reduced in MIA group as compared to SA group (p< 0.05). Average operation times were not different (p=0.259). Improving in VAS scores and HHS was significantly better in MIA group (p< 0.001). Postoperative SF-36 scores were significantly higher in both groups as compared to preoperative scores (p< 0.05). No sign of looseing, osteolysis, superficial or deep wound infection were detected in both groups.

Conclusion: Total hip arthroplasty by MIA exposure reduces length of hospital stay, leads to better pain control and rehabilitation in early period, causes less blood loss and leads to significant improvement in SF 36 scores. We suggest that after completion of learning curve, total hip arthroplasty by MIA exposure can be performed more effectively and with less complication.