Enhanced recovery after posterior minimally invasive total hip arthroplasty with continuous intraarticular...

The aim of this study was to evaluate the possible complications specific to the continuous intraarticular anaesthesia (CIA) in a minimally invasive posterior approach in total hip arthroplasty and its possible effects on the recovery, especially on pain and the length of hospitalisation.

The surgical procedure is first precisely described step by step with numerous per-operating photographs. Particular technical points are detailed. The errors to be avoided are specified. A prospective series of 70 first-line total hip arthroplasties (one half with and one half without CIA) are analysed for the well-known results of total hip arthroplasty but specifically assessing: (a) specific possible complications to the minimally invasive posterior technique with the prolonged local anaesthesia and (b) effects on pain, duration of hospitalisation and satisfaction in patients (questionnaire).

(a) Very low level of immediate post-operative pain was observed in almost all of the patients. (b) Patient satisfaction was high in our series. (c) A repeated education was provided multiple times to avoid specific complications following the absence of pain and consequent inattention.

The minimally invasive posterior approach with continuous intraarticular anaesthesia is an entirely reliable hip arthroplasty procedure. The patients exhibited a significantly less pain and a fast rate of recovery, but preparatory education must be even more significant.