Comparative Study Of Posterolateral And Traditional Approaches For Minimally Invasive Surgery Total Hip Arthroplasty

Objective: To compare the clinical effect of posterolateral and traditional approaches for mini-incision or minimally invasive surgery (MIS) total hip arthroplasty (THA) .Methods: from January, 2007 to January, 2008, 38 patients (41 hips) were performed with MIS THA using the modified posterolateral approach for the treatment of patients with hip disease (Mini-incision group) . For comparison, 15 patients (15 hips) were performed with standard THA at the same period (Conventional incision group ) .Mini-incision group:23 Male patients (25 hips).15Female patients (16 hips), age (53.2±15.5) years old. Body mass index (BMI) was 23.4±3.3. 20 cases (20 hips) of femoral neck fracture, 2 cases (2 hips) of primary osteoarthritis, III or IV stages of femoral head avascular necrosis in 14 cases(16 hips),2 cases (3 hips) of Ankylosing spondylitis involving hip joint. Harris hip scoring was (47.7±5.5). course of disease was (4.5±4.3) years Conventional incision group: 7 Male patients (7 hips), 8Female patients (8 hips), age (54.8±10.8) years old. BMI was 26.1±5.1. 6 cases (6 hips) of Fresh femoral neck fracture, 2 cases (2 hips) of old femoral neck fracture, 1 cases (1 hips) of primary osteoarthritis, 5 cases(5 hips) of III or IV stage aseptic necrosis of femoral head, 1 cases (1 hips) of Ankylosing spondylitis involving hip joint. Harris hip scoring was (47.7±5.5). course of disease was (3.8±3.7) years. General information on two groups of comparison, there was no statistics significance (P <0.05).Results Two groups of incision length, perioperative blood loss, drainage volume and blood volume compared, the difference has statistical significance(P<0.05);There were no differences between the two approaches with regard to operating time, prosthetic position and Harris scoring (P>0.05) Patients were stage I incision healed, no early-related complications occurred. Two groups of patients were followed up for 12 ~ 22 months, an average of 18.3 months. Patients in the postoperative 2-3 months disposable Po walking. Mini-incision group and the conventional incision group after 6 months, respectively, for the Harris scoring (88.60±3.6) and (85.80±3.3); comparison between the two groups was no significant difference (P> 0.05), with the same group of preoperative have statistically significant difference between (P <0.05).Conclusion MIS THA using the modified posterolateral approach with less trauma, less bleeding, faster postoperative recovery, shorter hospitalization time, less complications, femoral prosthesis treatment convenience and accurate positioning, but strictly operative indication.