Modified minimally invasive total hip arthroplasty through a lateral approach in 43 cases

From March 2004 to March 2005, 43 patients (49 hips) admitted to Department of Orthopedic Surgery, Fushun Central Hospital for minimally invasive total hip arthroplasty (THA) were selected, including 22 male and 21 female aged 22-79 years. All patients underwent THA with cementless prosthesis. The preoperative Harris scores were (46.2±5.3). For comparison, 35 patients (43 hips) were selected undergoing standard THA at the same period, including 22 male and 13 female, aged 31-78 years; 16 patients underwent THA with mixed prosthesis (cementless prosthesis for acetabulum; cemented prosthesis for the femur), and the others with cementless prosthesis. Their preoperative Harris scores were (43.4±4.6). The perioperative bleeding, operation time, incision length, postoperative functional recovery, and prosthetic position were compared. The THA was succeeded in all patients, and all subjects were followed up for 13.1 months averagely. The perioperative bleeding, drainage, blood transfusion and incision length in minimally invasive THA group were significantly less than standard group (P < 0.05); the postoperative Harris scores in minimally invasive THA and standard THA groups were (89.0±6.1) and (88.1±7.4) respectively. The prosthetic position was good in both minimally invasive and standard THA. Dislocation appeared in one patient with standard THA at two days after operation and restored by two-week traction and functional exercise. No complications occurred in minimally invasive THA. The minimally invasive THA can be indicated in selected patients with hip disorders. It has small trauma, little blood loss, good cosmetic incision and rapid recovery of function. However, the operation indications should be selected rigidly.