A MINIMAL INCISION APPROACH FOR TOTAL HIP ARTHROPLASTY

This paper reviews the potential advantages and disadvantages of minimal incision total hip arthroplasty (THA). A ‘mini-incision’ approach has been developed, with incision size decreasing to 7.5 mm to 8.5 mm over the past four years. This allows for adequate exposure and proper component positioning, and consistently good results have been achieved in over 400 patients. Using a posterior approach, an oblique skin incision is made. The approach permits insertion of acetabular fixation screws, and the technique can be used for both cemented and non-cemented implants. New retractors have been developed to protect the proximal angle of the incision and elevate the femur for femoral preparation, and a new acetabular inserter developed to protect the distal pole of the incision. Results have been excellent. There have been no dislocations and no cases of sciatic nerve palsy. The mean length of hospital stay is three days and mean operative time (skin to skin) 44.9 minutes.