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Published in: Clinical Orthopaedics and Related Research® 6/2009

01-06-2009 | Symposium: Advanced Techniques for Rehabilitation after Total Hip and Knee Arthroplasty

Early Discharge and Recovery with Three Minimally Invasive Total Hip Arthroplasty Approaches: A Preliminary Study

Authors: R. Michael Meneghini, MD, Shelly A. Smits, RN

Published in: Clinical Orthopaedics and Related Research® | Issue 6/2009

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Abstract

Purported advantages of THA performed with minimally invasive surgical approaches include less muscle damage and faster recovery. The purpose of this preliminary investigation was to determine if differences existed between minimally invasive approaches in hospital discharge and early functional recovery in THA patients with a rapid rehabilitation protocol. Twenty-four consecutive patients were randomized to one of three minimally invasive surgical approaches (two-incision, mini-posterior, and mini-anterolateral) and enrolled in an aggressive postoperative rehabilitation program. Hospital discharge, early functional milestone recovery, and validated outcome measures (SF-36, WOMAC, Harris hip score, lower extremity activity scale) were collected. All patients met hospital discharge criteria no later than the first postoperative day. There was no difference in hospital discharge, functional milestone recovery, or validated outcome measures during the first year after surgery with the numbers available. There were no complications directly related to early hospital discharge or the aggressive rehabilitation protocol. While the data suggest earlier hospital discharge and rapid rehabilitation protocols may be implemented successfully we found no difference between the three minimally invasive approaches in early hospital discharge or early functional recovery utilizing a rapid rehabilitation protocol.
Level of Evidence: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
Literature
1.
go back to reference Archibeck MJ, White RE Jr. Learning curve for the two-incision total hip replacement. Clin Orthop Relat Res. 2004;429:232–238.PubMedCrossRef Archibeck MJ, White RE Jr. Learning curve for the two-incision total hip replacement. Clin Orthop Relat Res. 2004;429:232–238.PubMedCrossRef
2.
go back to reference Bal BS, Haltom D, Aleto T, Barrett M. Early complications of primary total hip replacement performed with a two-incision minimally invasive technique. J Bone Joint Surg Am. 2005;87:2432–2438.PubMedCrossRef Bal BS, Haltom D, Aleto T, Barrett M. Early complications of primary total hip replacement performed with a two-incision minimally invasive technique. J Bone Joint Surg Am. 2005;87:2432–2438.PubMedCrossRef
3.
go back to reference Bellamy N, Wells G, Campbell J. Relationship between severity and clinical importance of symptoms in osteoarthritis. Clin Rheumatol. 1991;10:138–143.PubMedCrossRef Bellamy N, Wells G, Campbell J. Relationship between severity and clinical importance of symptoms in osteoarthritis. Clin Rheumatol. 1991;10:138–143.PubMedCrossRef
4.
go back to reference Berger RA. Total hip arthroplasty using the minimally invasive two-incision approach. Clin Orthop Relat Res. 2003;417:232–241.PubMed Berger RA. Total hip arthroplasty using the minimally invasive two-incision approach. Clin Orthop Relat Res. 2003;417:232–241.PubMed
5.
go back to reference Berger RA. Mini-incision total hip replacement using an anterolateral approach: technique and results. Orthop Clin North Am. 2004;35:143–151.PubMedCrossRef Berger RA. Mini-incision total hip replacement using an anterolateral approach: technique and results. Orthop Clin North Am. 2004;35:143–151.PubMedCrossRef
6.
go back to reference Berger RA, Duwelius PJ. The two-incision minimally invasive total hip arthroplasty: technique and results. Orthop Clin North Am. 2004;35:163–172.PubMedCrossRef Berger RA, Duwelius PJ. The two-incision minimally invasive total hip arthroplasty: technique and results. Orthop Clin North Am. 2004;35:163–172.PubMedCrossRef
7.
go back to reference Berger RA, Jacobs JJ, Meneghini RM, Della Valle C, Paprosky W, Rosenberg AG. Rapid rehabilitation and recovery with minimally invasive total hip arthroplasty. Clin Orthop Relat Res. 2004;429:239–247.PubMedCrossRef Berger RA, Jacobs JJ, Meneghini RM, Della Valle C, Paprosky W, Rosenberg AG. Rapid rehabilitation and recovery with minimally invasive total hip arthroplasty. Clin Orthop Relat Res. 2004;429:239–247.PubMedCrossRef
8.
go back to reference Berry DJ, Berger RA, Callaghan JJ, Dorr LD, Duwelius PJ, Hartzband MA, Lieberman JR, Mears DC. Minimally invasive total hip arthroplasty: development, early results, and a critical analysis. Presented at the Annual Meeting of the American Orthopaedic Association, Charleston, South Carolina, USA, June 14, 2003. J Bone Joint Surg Am. 2003;85:2235–2246. Berry DJ, Berger RA, Callaghan JJ, Dorr LD, Duwelius PJ, Hartzband MA, Lieberman JR, Mears DC. Minimally invasive total hip arthroplasty: development, early results, and a critical analysis. Presented at the Annual Meeting of the American Orthopaedic Association, Charleston, South Carolina, USA, June 14, 2003. J Bone Joint Surg Am. 2003;85:2235–2246.
9.
go back to reference Chimento GF, Pavone V, Sharrock N, Kahn B, Cahill J, Sculco TP. Minimally invasive total hip arthroplasty: a prospective randomized study. J Arthroplasty. 2005;20:139–144.PubMedCrossRef Chimento GF, Pavone V, Sharrock N, Kahn B, Cahill J, Sculco TP. Minimally invasive total hip arthroplasty: a prospective randomized study. J Arthroplasty. 2005;20:139–144.PubMedCrossRef
10.
go back to reference Crowe J, Henderson J. Pre-arthroplasty rehabilitation is effective in reducing hospital stay. Can J Occup Ther. 2003;70:88–96.PubMed Crowe J, Henderson J. Pre-arthroplasty rehabilitation is effective in reducing hospital stay. Can J Occup Ther. 2003;70:88–96.PubMed
11.
go back to reference DiGioia AM 3rd, Plakseychuk AY, Levison TJ, Jaramaz B. Mini-incision technique for total hip arthroplasty with navigation. J Arthroplasty. 2003;18:123–128.PubMedCrossRef DiGioia AM 3rd, Plakseychuk AY, Levison TJ, Jaramaz B. Mini-incision technique for total hip arthroplasty with navigation. J Arthroplasty. 2003;18:123–128.PubMedCrossRef
12.
go back to reference Dorr LD, Maheshwari AV, Long WT, Wan Z, Sirianni LE. Early pain relief and function after posterior minimally invasive and conventional total hip arthroplasty: a prospective, randomized, blinded study. J Bone Joint Surg Am. 2007;89:1153–1160.PubMedCrossRef Dorr LD, Maheshwari AV, Long WT, Wan Z, Sirianni LE. Early pain relief and function after posterior minimally invasive and conventional total hip arthroplasty: a prospective, randomized, blinded study. J Bone Joint Surg Am. 2007;89:1153–1160.PubMedCrossRef
13.
go back to reference Duwelius PJ, Burkhart RL, Hayhurst JO, Moller H, Butler JB. Comparison of the 2-incision and mini-incision posterior total hip arthroplasty technique: a retrospective match-pair controlled study. J Arthroplasty. 2007;22:48–56.PubMedCrossRef Duwelius PJ, Burkhart RL, Hayhurst JO, Moller H, Butler JB. Comparison of the 2-incision and mini-incision posterior total hip arthroplasty technique: a retrospective match-pair controlled study. J Arthroplasty. 2007;22:48–56.PubMedCrossRef
14.
go back to reference Ethgen O, Bruyere O, Richy F, Dardennes C, Reginster JY. Health-related quality of life in total hip and total knee arthroplasty: a qualitative and systematic review of the literature. J Bone Joint Surg Am. 2004;86:963–974.PubMed Ethgen O, Bruyere O, Richy F, Dardennes C, Reginster JY. Health-related quality of life in total hip and total knee arthroplasty: a qualitative and systematic review of the literature. J Bone Joint Surg Am. 2004;86:963–974.PubMed
15.
go back to reference Hardinge K. The direct lateral approach to the hip. J Bone Joint Surg Br. 1982;64:17–19.PubMed Hardinge K. The direct lateral approach to the hip. J Bone Joint Surg Br. 1982;64:17–19.PubMed
16.
go back to reference Harris WH. 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. 1969;51:737–755.PubMed Harris WH. 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. 1969;51:737–755.PubMed
17.
go back to reference Hartzband MA. Posterolateral minimal incision for total hip replacement: technique and early results. Orthop Clin North Am. 2004;35:119–129.PubMedCrossRef Hartzband MA. Posterolateral minimal incision for total hip replacement: technique and early results. Orthop Clin North Am. 2004;35:119–129.PubMedCrossRef
18.
go back to reference Kennon RE, Keggi JM, Wetmore RS, Zatorski LE, Huo MH, Keggi KJ. Total hip arthroplasty through a minimally invasive anterior surgical approach. J Bone Joint Surg Am. 2003;85(Suppl 4):39–48.PubMed Kennon RE, Keggi JM, Wetmore RS, Zatorski LE, Huo MH, Keggi KJ. Total hip arthroplasty through a minimally invasive anterior surgical approach. J Bone Joint Surg Am. 2003;85(Suppl 4):39–48.PubMed
19.
go back to reference Ogonda L, Wilson R, Archbold P, Lawlor M, Humphreys P, O’Brien S, Beverland D. A minimal-incision technique in total hip arthroplasty does not improve early postoperative outcomes: a prospective, randomized, controlled trial. J Bone Joint Surg Am. 2005;87:701–710.PubMedCrossRef Ogonda L, Wilson R, Archbold P, Lawlor M, Humphreys P, O’Brien S, Beverland D. A minimal-incision technique in total hip arthroplasty does not improve early postoperative outcomes: a prospective, randomized, controlled trial. J Bone Joint Surg Am. 2005;87:701–710.PubMedCrossRef
20.
go back to reference Pagnano MW, Leone J, Lewallen DG, Hanssen AD. Two-incision THA had modest outcomes and some substantial complications. Clin Orthop Relat Res. 2005;441:86–90.PubMedCrossRef Pagnano MW, Leone J, Lewallen DG, Hanssen AD. Two-incision THA had modest outcomes and some substantial complications. Clin Orthop Relat Res. 2005;441:86–90.PubMedCrossRef
21.
go back to reference Pagnano MW, Trousdale RT, Meneghini RM, Hanssen AD. Patients preferred a mini-posterior THA to a contralateral two-incision THA. Clin Orthop Relat Res. 2006;453:156–159.PubMedCrossRef Pagnano MW, Trousdale RT, Meneghini RM, Hanssen AD. Patients preferred a mini-posterior THA to a contralateral two-incision THA. Clin Orthop Relat Res. 2006;453:156–159.PubMedCrossRef
22.
go back to reference Pagnano MW, Trousdale RT, Meneghini RM, Hanssen AD. Slower recovery after two-incision than mini-posterior-incision total hip arthroplasty: a randomized clinical trial. J Bone Joint Surg Am. 2008;90:1000–1006.PubMedCrossRef Pagnano MW, Trousdale RT, Meneghini RM, Hanssen AD. Slower recovery after two-incision than mini-posterior-incision total hip arthroplasty: a randomized clinical trial. J Bone Joint Surg Am. 2008;90:1000–1006.PubMedCrossRef
23.
go back to reference Pour AE, Parvizi J, Sharkey PF, Hozack WJ, Rothman RH. Minimally invasive hip arthroplasty: what role does patient preconditioning play? J Bone Joint Surg Am. 2007;89:1920–1927.PubMedCrossRef Pour AE, Parvizi J, Sharkey PF, Hozack WJ, Rothman RH. Minimally invasive hip arthroplasty: what role does patient preconditioning play? J Bone Joint Surg Am. 2007;89:1920–1927.PubMedCrossRef
24.
go back to reference Ritter MA, Albohm MJ, Keating EM, Faris PM, Meding JB. Comparative outcomes of total joint arthroplasty. J Arthroplasty. 1995;10:737–741.PubMedCrossRef Ritter MA, Albohm MJ, Keating EM, Faris PM, Meding JB. Comparative outcomes of total joint arthroplasty. J Arthroplasty. 1995;10:737–741.PubMedCrossRef
25.
go back to reference Saleh KJ, Mulhall KJ, Bershadsky B, Ghomrawi HM, White LE, Buyea CM, Krackow KA. Development and validation of a lower-extremity activity scale: use for patients treated with revision total knee arthroplasty. J Bone Joint Surg Am. 2005;87:1985–1994.PubMedCrossRef Saleh KJ, Mulhall KJ, Bershadsky B, Ghomrawi HM, White LE, Buyea CM, Krackow KA. Development and validation of a lower-extremity activity scale: use for patients treated with revision total knee arthroplasty. J Bone Joint Surg Am. 2005;87:1985–1994.PubMedCrossRef
26.
go back to reference Sculco TP. Minimally invasive total hip arthroplasty: in the affirmative. J Arthroplasty. 2004;19(4 Suppl 1):78–80.PubMedCrossRef Sculco TP. Minimally invasive total hip arthroplasty: in the affirmative. J Arthroplasty. 2004;19(4 Suppl 1):78–80.PubMedCrossRef
27.
go back to reference Ware JE Jr, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992;30:473–483.PubMedCrossRef Ware JE Jr, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992;30:473–483.PubMedCrossRef
28.
go back to reference Wenz JF, Gurkan I, Jibodh SR. Mini-incision total hip arthroplasty: a comparative assessment of perioperative outcomes. Orthopedics. 2002;25:1031–1043.PubMed Wenz JF, Gurkan I, Jibodh SR. Mini-incision total hip arthroplasty: a comparative assessment of perioperative outcomes. Orthopedics. 2002;25:1031–1043.PubMed
Metadata
Title
Early Discharge and Recovery with Three Minimally Invasive Total Hip Arthroplasty Approaches: A Preliminary Study
Authors
R. Michael Meneghini, MD
Shelly A. Smits, RN
Publication date
01-06-2009
Publisher
Springer-Verlag
Published in
Clinical Orthopaedics and Related Research® / Issue 6/2009
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI
https://doi.org/10.1007/s11999-009-0729-6

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