The influence of incision length on immediate postoperative rehabilitation after total hip replacement

It has been suggested that smaller skin incisions may be associated with a better short-term outcome after total hip replacement, including a more rapid rehabilitation. The definition of mini-incision is still unclear as publications with incisions ranging from five to 20cm appear in the literature. We therefore prospectively studied 42 consecutive patients who had undergone 44 total hip replacements using a posterolateral approach, through skin incisions of between 10 and 21cm. The patients were assessed for their speed of postoperative rehabilitation and their length of hospital stay. Age, body mass index, length of incision, duration of procedure, muscles detached and repaired, and blood loss were also recorded. We found no evidence of a correlation between incision size and blood loss, postoperative rehabilitation, or the length of hospital stay. Similarly, the degree of surgical muscle trauma showed no evidence of a correlation with the speed of post-operative rehabilitation or the length of hospital stay. In contrast, the age of the patient did significantly correlate with the length of hospital stay and rehabilitation scores. Our study showed no evidence that the size of the incision, or the muscles detached or repaired at surgery, influenced the immediate postoperative rehabilitation after total hip replacement performed through a posterior approach. Only the patients age showed a correlation with the speed of rehabilitation. (Hip International 2005; 15: 102-7).