Top

Archives of Orthopaedic and Trauma Surgery

Published in:

01-12-2009 | Orthopaedic Surgery

Minimally invasive total hip arthroplasty: a randomized controlled prospective trial

Authors: Farhad Mazoochian, Patrick Weber, Sara Schramm, Sandra Utzschneider, Andreas Fottner, Volkmar Jansson

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 12/2009

Abstract

Introduction

Advantages of minimally invasive total hip arthroplasty (THA) are controversially discussed.

Method

In this prospective study 51 patients (52 hips) were randomly allocated to a classical lateral or a minimally invasive approach (modification of the Hardinge-approach). Operating time, intraoperative blood loss, postoperative hemoglobin, muscle enzymes CK and myoglobin were recorded. Radiologically the positioning of the prosthesis was analyzed. WOMAC- and Harris Hip Score (HHS) were assessed preoperatively, at discharge, at 6 weeks and 3 months.

Results

In the minimally invasive group there was a shorter length of surgery, the scores in the WOMAC and HHS were slightly better at discharge and at the 3 months- examination, myoglobin-rise was slightly less. The positioning of the prosthesis was good in both groups. Minimally invasive THA led to a quicker recovery, at 3 months postoperative there was still a slight difference to the standard group.

Conclusion

If these slight differences subside has to be examined in studies with a longer follow-up.

Mack MJ (2001) Minimally invasive and robotic surgery. JAMA 285:568–572CrossRefPubMed

Rothschild JG (1998) What alternatives has minimally invasive surgery provided the surgeon? Arch Surg 133:1156–1159CrossRefPubMed

Muller PE, Pellengahr C, Witt M, Kircher J, Refior HJ, Jansson V (2004) Influence of minimally invasive surgery on implant positioning and the functional outcome for medial unicompartmental knee arthroplasty. J Arthroplasty 19:296–301CrossRefPubMed

Wright JM, Crockett HC, Delgado S, Lyman S, Madsen M, Sculco TP (2004) Mini-incision for total hip arthroplasty: a prospective, controlled investigation with 5-year follow-up evaluation. J Arthroplasty 19:538–545CrossRefPubMed

Goldstein WM, Branson JJ (2004) Posterior-lateral approach to minimal incision total hip arthroplasty. Orthop Clin North Am 35:131–136CrossRefPubMed

Laffosse JM, Accadbled F, Molinier F, Chiron P, Hocine B, Puget J (2008) Anterolateral mini-invasive versus posterior mini-invasive approach for primary total hip replacement. Comparison of exposure and implant positioning. Arch Orthop Trauma Surg 128:363–369CrossRefPubMed

Lukoschek M, Breusch SJ (2005) Minimal Incision Approaches to the Hip. In: Breusch SJ, Malchau H (eds) The well-cemented total hip arthroplasty, 1st edn. Springer, Berlin, pp 2–15

Sculco TP, Jordan LC, Walter WL (2004) Minimally invasive total hip arthroplasty: the hospital for special surgery experience. Orthop Clin North Am 35:137–142CrossRefPubMed

Chen DW, Hu CC, Chang YH, Yang WE, Lee MS (2008) Comparison of clinical outcome in primary total hip arthroplasty by conventional anterolateral transgluteal or 2-incision approach a retrospective, case-controlled investigation with 2-year follow-up. J Arthroplasty. [Epub ahead of print]

10.

Howell JR, Masri BA, Duncan CP (2004) Minimally invasive versus standard incision anterolateral hip replacement: a comparative study. Orthop Clin North Am 35:153–162CrossRefPubMed

11.

Murphy SB, Tannast M (2006) Conventional vs minimally invasive total hip arthroplasty. A prospective study of rehabilitation and complications. Orthopade 35:761–768CrossRefPubMed

12.

Vicente JR, Croci AT, Camargo OP (2008) Blood loss in the minimally invasive posterior approach to total hip arthroplasty: a comparative study. Clinics 63:351–356CrossRefPubMed

13.

Dosanjh S, Matta JM, Bhandari M (2008) The final straw: a qualitative study to explore patient decisions to undergo total hip arthroplasty. Arch Orthop Trauma Surg 129:719–727CrossRefPubMed

14.

Najarian BC, Kilgore JE, Markel DC (2009) Evaluation of component positioning in primary total hip arthroplasty using an imageless navigation device compared with traditional methods. J Arthroplasty 24:15–21

15.

Williams SL, Bachison C, Michelson JD, Manner PA (2008) Component position in 2-incision minimally invasive total hip arthroplasty compared to standard total hip arthroplasty. J Arthroplasty 2008(23):197–202CrossRef

16.

Woolson ST, Mow CS, Syquia JF, Lannin JV, Schurman DJ (2004) Comparison of primary total hip replacements performed with a standard incision or a mini-incision. J Bone Joint Surg Am 86-A:1353–1358PubMed

17.

American Society of Anesthesiologists (1963) New classification of physical status. Anesthesiology 24:111–114

18.

Bauer R, Kerschbaumer F, Poisel S, Oberthaler W (1979) The transgluteal approach to the hip joint. Arch Orthop Trauma Surg 95:47–49CrossRefPubMed

19.

Hardinge K (1982) The direct lateral approach to the hip. J Bone Joint Surg Br 64:17–19PubMed

20.

Bos JC, Stoeckart R, Klooswijk AI, van LB, Bahadoer R (1994) The surgical anatomy of the superior gluteal nerve and anatomical radiologic bases of the direct lateral approach to the hip. Surg Radiol Anat 16:253–258CrossRefPubMed

21.

Nazarian S, Tisserand P, Brunet C, Muller ME (1987) Anatomic basis of the transgluteal approach to the hip. Surg Radiol Anat 9:27–35CrossRefPubMed

22.

Akeson J, Bostrom PA, Gustafson C, Rosberg B (1989) Serum CK-MB is useful in diagnosis of acute myocardial infarction after total hip arthroplasty. Acta Anaesthesiol Scand 33:435–438CrossRefPubMed

23.

Harris WH (1969) Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg Am 51:737–755PubMed

24.

Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW (1988) Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol 15:1833–1840PubMed

25.

Hungerford DS (2004) Minimally invasive total hip arthroplasty: in opposition. J Arthroplasty 19(4 Suppl 1):81–82CrossRefPubMed

26.

Sculco TP (2004) Minimally invasive total hip arthroplasty: in the affirmative. J Arthroplasty 19(4 Suppl 1):78–80CrossRefPubMed

27.

Ogonda L, Wilson R, Archbold P, Lawlor M, Humphreys P, O’Brien S et al (2005) A minimal-incision technique in total hip arthroplasty does not improve early postoperative outcomes. A prospective, randomized, controlled trial. J Bone Joint Surg Am 87:701–710CrossRefPubMed

28.

Fehring TK, Mason JB (2005) Catastrophic complications of minimally invasive hip surgery. A series of three cases. J Bone Joint Surg Am; 87:711–714CrossRefPubMed

29.

Mardones R, Pagnano MW, Nemanich JP, Trousdale RT (2005) The Frank Stinchfield Award: muscle damage after total hip arthroplasty done with the two-incision and mini-posterior techniques. Clin Orthop Relat Res 2005 441:63–67CrossRef

30.

Heimkes B, Posel P, Bolkart M (1992) The transgluteal approaches to the hip. Arch Orthop Trauma Surg 111:220–223CrossRefPubMed

31.

Ciminiello M, Parvizi J, Sharkey PF, Eslampour A, Rothman RH (2006) Total hip arthroplasty: is small incision better? J Arthroplasty 21:484–488CrossRefPubMed

32.

Goldstein WM, Branson JJ (2004) Posterior-lateral approach to minimal incision total hip arthroplasty. Orthop Clin North Am 35:131–136CrossRefPubMed

33.

Musil D, Stehlik J, Verner M (2008) A comparison of operative invasiveness in minimally invasive anterolateral hip replacement (MIS-AL) and standard hip procedure, using biochemical markers. Acta Chir Orthop Traumatol Cech 2008(75):16–20

34.

Laurence AS (2000) Serum myoglobin and creatine kinase following surgery. Br J Anaesth 84:763–766PubMed

35.

Thomas L (2005) Myoglobin. In: Thomas L (ed) Labor und diagnose, 6th edn. TH-Books-Verlags-Gesellschaft, Frankfurt/Main, pp 135–137

36.

Mikkelsen TS, Toft P (2005) Prognostic value, kinetics and effect of CVVHDF on serum of the myoglobin and creatine kinase in critically ill patients with rhabdomyolysis. Acta Anaesthesiol Scand 49:859–864CrossRefPubMed

37.

Sayers SP, Clarkson PM (2003) Short-term immobilization after eccentric exercise. Part II: creatine kinase and myoglobin. Med Sci Sports Exerc; 35:762–768CrossRefPubMed

38.

Szendroi M, Sztrinkai G, Vass R, Kiss J (2006) The impact of minimally invasive total hip arthroplasty on the standard procedure. Int Orthop 30:167–171CrossRefPubMed

Title: Minimally invasive total hip arthroplasty: a randomized controlled prospective trial
Authors: Farhad Mazoochian
Patrick Weber
Sara Schramm
Sandra Utzschneider
Andreas Fottner
Volkmar Jansson
Publication date: 01-12-2009
Publisher: Springer-Verlag
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 12/2009
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-009-0870-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Minimally invasive total hip arthroplasty: a randomized controlled prospective trial

Abstract

Introduction

Method

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Method

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 12/2009

Serum acid phosphatase can be a useful tumour marker for giant cell tumour of bone

Treatment of displaced intra-articular calcaneal fractures by ligamentotaxis: current concepts’ review

Primary non-Hodgkin’s lymphoma of the lumbar vertebrae mimicking tuberculous spondylitis: a case report

An alternative treatment method to restore limb-length discrepancy in osteoarthritis with high congenital hip dislocation

Long-term results of surgical release of trigger finger and trigger thumb in adults

Risk factors for revision total hip arthroplasty: emphasis on the characteristics of Japanese lifestyle