Our goals were to minimize the invasiveness of the revision hip arthroplasty approach in order to accelerate the patient's rehabilitation, shorten the length of hospitalization and reduce the postoperative complications, especially the rate of joint dislocation. Our study aimed to prove whether and under which conditions the less invasive approach is preferable in revision arthroplasty. The modified revision technique differs from the conventional approach in the following main aspects: Oncologic: applying larger hip balls and inserts, after expanding the variety of the available articulating joint components in 4 mm steps (28–40 mm), sparing and reconstructing the joint capsule, whereby the integrity of its acetabular origin is crucial. That procedure was combined with tissue dissection strictly parallel to the direction of the muscle fibers. The transgluteal approach after Bauer was applied. The small skin incision was closed by running subcuticular technique. The inpatient postoperative phase after revision total hip arthroplasty was evaluated in the last 6.5 years. All patients completed a questionnaire.Aim
Material and Methods
Selecting the most appropriate size of hip ball among a different variety ranging from 28–44 mm in diameter, in order to simulate the size of the resected femur head and increase the joint stability as much as possible. Sparing and completely reconstructing the joint capsule, especially its acetabular origin. Muscular and iliotibial tract incisions are made parallel to the direction of fibres in order to facilitate optimal surgical reconstruction. Small skin incision together with using absorbable subcuticular skin closure technique to reduce postoperative wound complications. 1004 cases of primary THA and 36 cases of THA revision were evaluated after applying the less invasive technique. A questionnaire was designed to evaluate the patient’s satisfaction regarding pain and function, necessary reoperations, complications such as dislocation or wound dehiscence and leg length discrepancy. Additionally, Symptoms and function were assessed by WOMAC Osteoarthritis Index.
