THA Performed using Conventional and Navigated Tissue-preserving Techniques

Abstract

Less invasive methods of performing total hip arthroplasty have been considered controversial after increased complication rates and component malpositioning were reported. A new method of performing total hip arthroplasty through an incision in the superior capsule, posterior to the abductors and anterior to the posterior capsule, was developed with the aim of producing a technique that maintained the joint stability of the transgluteal exposure and the rapid abductor recovery of the posterior exposure. We assessed the recovery and complications of this technique performed with surgical navigation. The study group was compared with similar subjects who had conventional total hip arthroplasty, without surgical navigation, using the transgluteal exposure. There were 185 consecutive total hip arthroplasties in the study group and 189 nonconsecutive historical total hip arthroplasties in the control group. The two groups were controlled for complexity and had no differences in body mass index, gender, diagnosis, operative side, bilateral operations, and previous surgeries. Patients were evaluated for clinical recovery and perioperative complications at 9 and 24 weeks. The study group recovered faster at both followup examinations. The study group had fewer perioperative and postoperative complications compared with the control group. Accuracy of component positioning was not compromised compared to the control group. Less invasive surgery with the philosophy of maximally preserving the abductors, posterior capsule, and short rotators may result in a safer operation with faster recovery than traditional techniques.

Tailor-made Surgical Guide Reduces Incidence of Outliers of Cup Placement

“…As a result, we found no difference in the operative time and blood loss between the two groups. The operation time and blood loss with the surgical guide were comparable to those reported for conventional and navigated THAs [12,18,20,26] (Table 3). Two previous reports suggest the navigation systems with an optical sensor take an additional 15 to 46 minutes of operating time over conventional procedures [1,30].…”

Minimally invasive total hip arthroplasty: a systematic review

“…Minimally invasive THA involves a modified surgical dissection that uses internervous planes while minimising any tendon or muscle trauma during the exposure [10,19,28,29]. High-technology computer navigation can be used for correct positioning of the components given the decreased visualisation of minimally invasive surgery [32,40]. Choice of implants and cementing techniques was highly variable across studies when reported.…”

Improving Cup Positioning Using a Mechanical Navigation Instrument

“…For all hips, a less invasive approach, the superior capsulotomy [13], was performed with the patient in the lateral decubitus position. The cups were impacted using an angled impactor and all the operations were performed by one surgeon (SBM).…”