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No differences in early outcomes for mini-incision or two-incision THA
Della Valle CJ. Clin Orthop Relat Res. Published online: July 2010.
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The mini-incision and two-incision approaches to total hip arthroplasty produced similar perioperative outcomes, according to results of this Level I study.
“Variables other than the surgical approach, including perioperative protocols, patient expectations, and the patient’s general health may have a greater effect on outcomes such as pain during the early postoperative period, functional recovery and length of hospital stay,” the authors wrote.
Craig Della Valle, MD, and colleagues at Rush University Medical Center, Chicago, prospectively enrolled 72 patients who were about to undergo total hip arthroplasty (THA). They randomized the patients into either a mini-approach group or a two-incision group. The following parameters were the same for all patients: preoperative teaching, anesthetic protocols, implant choice and rehabilitation. The researchers assessed all variables at a maximum of 1 year after surgery.
Both groups had similar results in this study’s key outcomes: mean visual analog scale, pain scores for the first 3 postoperative days and the first 6 weeks, total narcotic requirements in the hospital and during the first 6 weeks, mean length of stay, mean Harris hip and SF-12 scores. Patients in both groups achieved functional milestones at a similar rate.
One patient from each group required a reoperation. Mean operative time was longer in the two-incision group (98 minutes vs. 77 minutes), although the accuracy of component positioning was comparable, the authors wrote.