Abstract

COMPARISON OF RESULTS OF TOTAL HIP ARTHROPLASTY DONE WITH MINI INCISION (POSTERIOR MODIFIED) AND TRADITIONAL POSTERIOR APPROACH

Author(s): Vijay Kumar Meena1, Dayanand M2, Gunvanti Meena3, Siddharth Sharma4, Ankesh Goyal5

BACKGROUND
Total hip arthroplasty is one of the most successful procedures introduced in twentieth century. In this study, we compared total hip arthroplasty with mini incision (modified posterior) and standard posterior approach.
MATERIALS AND METHODS
Total of 96 hips were studied, 48 hips in mini incision group and 48 hips in control group. 84 patients were selected with primary total hip arthroplasty performed on a total of 96 hips during a period of June 2012 to September 2014. Out of 96 hips, 66 hips were avascular necrosis of head of femur, 3 rheumatoid arthritis, 9 ankylosing spondylitis, 3 central dislocation, 3 fracture neck of femur with broken SP nail. 48 hips were operated with mini incision and 48 hips operated with standard incision. Average age of the patients is 56 years in standard incision group and 47 years in mini incision group. Harris hip evaluation (modified) was used for recording the status of hip before surgery and postoperative results. The patients were compared with respect to the length of incision, surgical time, blood loss, acetabular cup placement, femoral stem placement, and complications. Radiological parameters included were abduction angle, stem alignment, and quality of cement mantle. Average follow up was 12 months. Patients were followed up in OPD for regular examination in three monthly intervals and functional assessment of the hip was done using the Harris hip score (modified).
RESULTS
Thinner, healthier, and younger patient were included in mini incision group as compared to the control group. The final outcome was to be statistically insignificant expect surgical time and blood loss and cosmetically. 95% of the patients had excellent to good functional result in mini incision group and 100% had good result in standard incision group. In our series, 6 patients had intraoperative hypotension in standard group due to excessive blood loss. 3 patient had stitch abscess, which healed during subsequent dressing, 3 patient had peroneal nerve palsy, and 6 patients had dislocation in mini incision group.
CONCLUSION
Our study defies most of benefits of mini incision technique. However, no improvements were seen in any of the parameters studied. Long-term studies are required to investigate the impact of the use of minimally invasive approach on the durability of replacements.