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[Complications on minimal access surgery for total hip arthroplasty]
José Dolores García Juárez1, Pedro Antonio Bravo Bernabé, Antonio García Hernández
1Hospital General de México, Servicio de Ortopedia, U-106, Dr. Balmis Núm. 148 Col. Doctores, C.P. 06720 México, D. F.
Introduction:
Recently, the surgical approach for total hip replacement has been refined and has been reduced in size. Controversies exist between advantages and complications it can present.
Objective:
To show the complications of total hip arthroplasty by means of minimal access approach.
Methods:
Thirty six patients, 24 women and 12 men (mean age 48 years), grade IV hip arthrosis. Twenty four patients underwent cementless hip arthroplasty and 12 patients hybrid arthroplasty. The preoperative evaluation was done with Harris score. An initial lateral approach of 6 cm (100%) was performed. Complications were grouped on acetabular, femoral and soft tissue complications.
Results:
Necrosis at the comissure of the wound was seen in 12 patients (33.33%), necrosis at the surface border of the wound in 10 patients (27.77%), mal positioning of the acetabular cup in 3 patients (8.33%), mal positioning of acetabular cup screws in 2 patients (5.55%), eccentric reaming of the acetabulum in one patient (2.77%), and femoral stem malalignment in one patients (2.77%).
Discussion:
There are many reports on the advantages of minimal invasion total hip replacement but few on complications which include mal positioning of the acetabular cup, eccentric reaming of the acetabulum and femoral stem malalignment. Nevertheless, advantages include a decreased healing time and postoperative recovery with less pain and reduced blood loss. We recommend that this technique should remain in the hands of experienced orthopaedic surgeons.
