Sauri AJC, Gutiérrez R, Tarazona VP, Sauri BJC

Language: Spanish
References: 8
Page: 2-5
PDF size: 66.35 Kb.

ABSTRACT

The objective of this paper is to know the real benefits of the minimally invasive to total hip replacement. Some authors have described with small incisions less soft tissue trauma, less pain, faster recovery and decreased blood loss. We studied two groups ten patients for each, Group I were operated total hip replacement with conventional incision and Group II with a minimally incision 10 cm or less in length. Was recorded in the two groups: age, sex, weight, diagnosis, transop bleeding, surgery time, blood transfuse required, time of walker and cane delivery, type of analgesia; X ray evaluation in relation of the acetabulum and stem orientation. Results. Average age in group I 76.2 years and group II 65.3 years; average weight group I 72.5 kg, group I 79.5 kg. Diagnosis was arthrosis in 18 patients and two patients avascular necrosis; average bleeding in group I was 644 cc and group II 400 cc. Surgery time in group I was 165 min and group II 170 min. Gait beginning in both group was in the first day postop with Crutches or walker only two patients in group II began on second day postop, change to a cane at the third week postop in 90% in group I and 84% in group II. Without aid at 6 weeks postop in group I 92% arid group II 90%. Conclusions. The two groups were similar in the parameters of: bleeding, blood, transfusion, gait without aid, use of analgesia, hospital discharge. Therefore the decision make is between the orthopedic surgeon and the patient. We found in 80% of the patients in group I redness and inflammation of the wound secondary to soft tissue traction and two cases of cup mal position.

REFERENCES

1. Berger R, Duwelius P: The Two-incision minimally invasive total hip arthroplasty: technique and results. Orthop Clin N Am 2004; 35: 163-172.

2. DiGioia A, Blendea S, Jamaraz B: Computer-assisted orthopaedic surgery: minimally invasive hip and knee reconstruction. Orthop Cli N Am 2004; 35: 183-189.

3. Goldstein W, Branson J: Postero-lateral approach to minimal incision total hip arthroplasty. Orthop Clin N Am 2004; 35: 131-136.

4. Howell J, Garbuz D, Duncan C: Minimally invasive hip replacement: rationale, applied anatomy, and instrumentation. Orthop Clin N Am 2004; 35: 107-118.

5. Howell J, Masri B, Duncan C: Minimally invasive versus standard incision anterolateral hip replacement: a comparative study. Orthop Clin N Am 2004; 35: 153-162.

6. Ilizaliturri V, Chaidez P, Valero F, Aguilera J: Small incision total hip replacement by the lateral approach using standard instruments. Orthopedics 2004; 27(4): 377-381.

7. Kennon R, Keggi J, Wetmore R, Ztorski L, Huo M, Keggi K: Total hip arthroplasty through a minimally invasive anterior surgical approach. J Bone Joint Surg 2003; 85-A(Suppl 4): 39-47.

8. Sculco T, Jordan L, Walter W: Minimally invasive total hip arthroplasty: the Hospital for Special Surgery experience. Orthop Clin N Am 2004; 35: 137-142.