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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
PAPERS ON HIP
Minerva Ortopedica e Traumatologica 2006 August;57(4):371-5
Minimally invasive total hip replacement. Anterolateral approach: indications, limitations, surgical technique
Mora R., Pedrotti L., Bertani B., Tuvo G., Pazzano S., Quattrini F.
Clinica Ortopedica e Traumatologica Università degli Studi di Pavia Polo Universitario “Città di Pavia”, Pavia
Aim. Minimally invasive total hip replacement, defined as a procedure performed with a small incision and a reduced damage to the soft tissues, must employ an interstitial (or intermuscular) surgical approach and must avoid any transmuscular surgical approach (according to the classification of Nazarian and Muller). Antero-lateral approach, developed by Watson-Jones, modified in a minimally invasive version and performed with the patient in supine position, offers several interesting anaesthesiological and surgical advantages, and minimizes the risk of postoperative dislocation. Surgical technique is based on a 7 to 10 cm incision. It doesn’t request the use of specialized instrumentation and allows an excellent visualization and an easy insertion of the acetabular cup and of the stem.
Methods. Seventy four cases of non cemented minimally invasive total hip arthroplasties, performed with the use of a “press-fit” type cup and a straight stem, were revised. The mean postoperative follow-up time was 24 months (min 6 months, max 42 months).
Results. Clinical and radiographic results are good and the aesthetic result is excellent. Reduced blood loss and faster functional recovery were not observed.
Conclusions. Therefore, further studies are needed in order to evaluate late functional and instrumental results.