Abstract
Purpose
To determine the effect of early recovery with 2 different MIS THA for patients with dysplastic hip because of relatively severe muscle weakness before surgery.
Materials & Methods
MIS THA (248 MIS A/L, 96 2-incision) were performed with single surgeon from 2002. Averaged age was 61 years old. Abductor muscle power and VAS score were analyzed preop, 3, 5 7, 14 days, 2, 6 and 12 months after surgery. Patients were prone position and MicroFET machine (HOGGAN Inc. USA) were used for this analysis. All analysis were performed with single observer (physical therapist).
Results
Averaged skin to skin surgical time was 62 min. in MIS A/L (A/L), 96 min. in 2-incision (2I). Hospital stay of MIS A/L were averaged 7 days, 10 in 2-incision and all were direct discharge to their home. Abductor muscle power was down in 3 days (2I; 40%, A/L; 65%: p<0.05) because of pain and swelling in both approach. But, better recovery in both group (2I: 58%, A/L; 75% p<0.05)) 5 days after surgery, and 80% in 2I, 90% A/L in 14 days (N/S). Six and 12 months results were higher compared contra-lateral normal side before surgery. VAS score in 14 days was better in 2-incision (14/100) compared to A/L (23/100). Both walking ability in 100meters with T cane, and stair climbing ability was not statistically significant in both groups.
Discussion & Conclusion
Muscle sparing MIS A/L approach had better muscle power recovery but less pain in 2-incision in 14 days (compared Hardinge approach recovery were 60% or less). MIS A/L required none fluoroscopy, had shorter surgical time compared to 2-incision, but indication for patients with limited range of motion and severe deformity with dysplasia need to clarify with more surgical cases.
