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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
Minerva Ortopedica e Traumatologica 2012 December;63(6):433-46
Anterolateral mini-incision hip replacement surgery: a modified watson-jones approach
Perrone V., Mega W.
Unità Operativa di Ortopedia e Traumatologia, Ospedale “S. Cuore di Gesù”, Gallipoli, Lecce, Italia
AIM:The purpose of this study is to describe our early experience in the development and use of a minimally invasive, anterolateral approach (ALMI) to the hip joint for total hip arthroplasty (THA). The minimal invasive Watson- Jones approach to the hip joint for THA retains advantages of the classic techinique, while avoid detachment of the abductor. The approach, originally described by Bertini and Rottinger, uses the same interval between gluteus medius and tensor fascia latae, but allow preservation of the abductor. Finzi has simplified the approach with the positioning of the patient on the operating table, and the maneuvers of presentation of the femur.
METHODS:Forty-three consecutive patients were surgically treated of hip arthroplasty. The procedure can be performed in semilateral decubitus position on a regular operation table, traction is not applied. The clinical results including pain, intra and postoperative complications, blood loss, component placement, incision length, length of hospital stay, functional score with Harris Hip Score.
RESULTS:The follow-up was between 7 month to 26 month. The mean operation time was 75 minutes. The average length of the anterior incision was 11 cm. The pain is significantly reduced, and there were significant reduction in blood loss. In the aspects of complications there was in this material 3 trochanter’s fractures, and 1 femoral fracture. No revision for aseptic loosening is recorded, no disclocations occurred. The average Harris score increased from preoperative 44.3 to post-operative 77.6 points at fifteen days and 89 at 2 months.
CONCLUSION: The ALMI showed good results in the short term follow-up. Further controlled studies are needed in the long term follow-up. The most important advantage of this approach is the quick rehabilitation.