Posterolateral minimal incision for total hip replacement: technique and early results

Hartzband, Mark A.

doi:10.1016/s0030-5898(03)00119-6

Cited by 93 publications

(34 citation statements)

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“…However, in recent years, there has been increasing focus on minimally invasive surgical approaches to THA because of the potential to improve perioperative outcomes and hasten patient recovery [2], [3], [4]. The anterior, or Smith-Petersen, surgical approach has been shown to improve functional recovery in the early postoperative period [5], [6], [7], [8], [9], [10].…”

Section: Introductionmentioning

confidence: 99%

“…The anterior, or Smith-Petersen, surgical approach has been shown to improve functional recovery in the early postoperative period [5], [6], [7], [8], [9], [10]. Although the AA and PA have comparable long-term success rates, discrepancy is reported in the early postoperative period [2], [4], [6], [11]. The anterior approach (AA) uses the intermuscular and internervous intervals between the sartorius and the tensor fascia lata muscles.…”

Section: Introductionmentioning

confidence: 99%

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Financial impact of total hip arthroplasty: a comparison of anterior versus posterior surgical approaches

2017

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BackgroundCompared to the posterior approach, the anterior approach to total hip arthroplasty (THA) offers the potential for an accelerated recovery secondary to less dissection and therefore less pain in the immediate postoperative period. This offers potential financial benefit through a reduction in length of stay. This study retrospectively reviewed 98 anterior approach and 69 posterior approach THA cases (N = 167) to compare perioperative outcomes and cost-effectiveness.MethodsPatients who underwent anterior approach THA were discharged sooner than those who underwent posterior approach THA.ResultsThe anterior approach was also less expensive per patient than the posterior approach. Overall, differences in perioperative outcomes between these approaches to THA are less robust than previously reported. There is a significant difference in operative cost between these surgical approaches.ConclusionsAlthough there are many sources for this difference in cost, the predominant contributor is surgeon implant preference.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Financial impact of total hip arthroplasty: a comparison of anterior versus posterior surgical approaches

2017

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“…After the introduction of MIS (incision length 10–12 cm or less [8, 12]) in THA, a debate started worldwide regarding the possible clinical benefits of this approach as compared with the classic approaches (CLASS) [8, 12]. The rationale for MIS is a minimized tissue dissection, resulting in reduced blood loss, pain, hospital stay, and faster rehabilitation [15].…”

Section: Introductionmentioning

confidence: 99%

Minimally Invasive versus Classic Procedures in Total Hip Arthroplasty: A Double-blind Randomized Controlled Trial

Goosen

Kollen

Castelein

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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BackgroundFor total hip arthroplasty (THA), minimally invasive surgery (MIS) uses a smaller incision and less muscle dissection than the classic approach (CLASS), and may lead to faster rehabilitation.Questions/purposesDoes minimally invasive hip arthroplasty result in superior clinical outcomes?Patients and MethodsIn this double-blind randomized controlled trial, 120 consecutive primary noncemented THAs in 120 patients were assigned to one of two groups (MIS or CLASS). The randomization sequence was stratified for two groups of surgeons, ie, those using a posterolateral approach (PL-CLASS or PL-MIS) and those using an anterolateral approach (AL-CLASS or AL-MIS). Length of the incisions was 18 cm for the CLASS procedures. MIS incisions were extended at the skin level to 18 cm at the end of the procedure. The primary end point was the Harris hip score (HHS) at 6 weeks postoperatively. Patient-centered questionnaires were obtained preoperatively and after 6 weeks and 1 year.ResultsFor the patients in the MIS group (average 7.8 cm incision length), statistically significant increased mean HHSs were seen compared with the CLASS group at 6 weeks and 1 year. This difference was small and mainly caused by the favorable results of the PL-MIS. In the MIS group, surgical time was longer. A learning curve was observed based on operation time and complication rate. Although not statistically significant, the perioperative complication rate was rather high in the (anterolateral) MIS group.ConclusionsThe minimal invasive approach in THA did not show a clinically relevant superior outcome in the first postoperative year.Level of Evidence Level I, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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“…cosmetic appearance [1][2][3][4][5][6][8][9][10][11][12][13][14][15][16][17][18] . Critics believe that the disadvantages include reduced operative visualization, a steep learning curve, an increased risk of neurovascular complications, a higher prevalence of dislocation, excessive skin trauma, and compromised implant fixation and positioning 1,7,[19][20][21][22][23][24] .…”

mentioning

confidence: 99%

Early Pain Relief and Function After Posterior Minimally Invasive and Conventional Total Hip Arthroplasty

Dorr

Maheshwari

Long

et al. 2007

The Journal of Bone & Joint Surgery

183

165

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Posterolateral minimal incision for total hip replacement: technique and early results

Cited by 93 publications

References 1 publication

Financial impact of total hip arthroplasty: a comparison of anterior versus posterior surgical approaches

Financial impact of total hip arthroplasty: a comparison of anterior versus posterior surgical approaches

Minimally Invasive versus Classic Procedures in Total Hip Arthroplasty: A Double-blind Randomized Controlled Trial

Early Pain Relief and Function After Posterior Minimally Invasive and Conventional Total Hip Arthroplasty

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