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Minimally invasive total hip replacement: the posterolateral approach
Friedrich Bottner1, Samuel Delgado, Thomas P Sculco
1Steadman Hawkins Clinic of the Carolinas, Spartanburg, SC, USA. drboettner@email.de
American Journal of Orthopedics (Belle Mead, N.J.)
|June 13, 2006
Summary
Mini-incision total hip arthroplasty offers cosmetic benefits but lacks dramatic clinical advantages over standard approaches. Surgeons should carefully consider patient selection and inform them about the true merits of mini-incision techniques.
Area of Science:
- Orthopedic Surgery
- Arthroplasty
Background:
- Mini-incision techniques for total hip arthroplasty (THA) are increasingly discussed.
- Concerns exist regarding their clinical efficacy compared to traditional methods.
Purpose of the Study:
- To evaluate the safety and effectiveness of the posterolateral mini-incision THA technique.
- To compare mini-incision approaches with standard THA regarding outcomes and complications.
Main Methods:
- Retrospective review of patient outcomes following posterolateral mini-incision THA over 8 years.
- Comparison of perioperative complication rates and surgical times with literature data for anterior and two-incision approaches.
Main Results:
- Posterolateral mini-incision THA is safe and effective in selected patients, with shortened operating times.
- Mini-incision approaches show complication rates similar to standard incisions, with lower rates than anterior or two-incision methods.
- No increased dislocation risk was observed with the posterior approach when external rotators and capsule were repaired.
Conclusions:
- Both anterolateral and posterior mini-incision THA are viable alternatives, with surgeon preference being a key factor.
- Mini-incision THA does not offer dramatic clinical benefits beyond cosmetic appeal compared to standard approaches.
- Informed patient consent regarding the true merits of mini-incision THA is crucial to avoid misleading marketing.