Abstract
Aim
The aim of this study was to compare a single-incision minimally invasive (MI) posterior approach with a standard posterior approach in a double-blind prospective randomised controlled trial.
Method
A pilot study was carried out to assess the efficacy of the MI approach. Primary total hip replacements meeting the inclusion criteria were randomised to either the MI approach or the standard posterior approach. Patients were blinded to allocation. Patients were scored by a blinded physiotherapist pre-operatively, at Day 2, 2 weeks and 6 weeks.
The primary outcome measure was function, assessed using the Oxford hip score, SF-12 questionnaire, Iowa score, 6-minute walk test and the number of walking aids required after 2 and 6 weeks post-operatively. Secondary outcomes were complication rates, patient satisfaction, soft tissue trauma and radiographic analysis.
Results
52 patients were admitted to the trial, 26 in each group. There was no significant difference between the characteristics of the groups. There was no statistically significant difference in operation time, length of stay, soft tissue trauma, perceived operation difficulty or complication rates. There was no significant difference between the groups with regards to the relative improvement in Oxford hip score, SF-12 Score, walking speed or 6 minute walk test. Statistical Significance did occur with regard to the number of walking aids used at the 2 week mark. 75% of those in the MIS group were able to use one or less aids, as opposed to only 41% of the standard group. However by the 6th week there was no longer statistical significance.
Conclusion
Our study suggests there is no real clinical difference between the single-incision MI posterior approach and the standard posterior approach for total hip arthroplasty with regards to function, patient satisfaction, soft tissue trauma and component positioning.
