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True Merit of a Mini-Incision THR

Posted on: 09/20/2004
Wouldn't it be great to have a total hip replacement (THR) with less pain? Faster recovery? Shorter time in the hospital with less blood loss? Smaller scar and fewer problems? These are a few of the claims being made for the mini-incision approach to THR. But how true are these claims?

According to researchers studying this topic, none of these statements has been proven. Improved appearance may be the only real advantage to the mini-approach to THR.

In this study two groups of patients getting a THR were compared. The first group had the mini-incision. The second group had the standard incision. There were 42 patients in each group. The mini-incision was about two inches long. The standard cut to open the hip was five to 10 inches long. The length of the opening was the only difference between the two groups. All other aspects of the operations were the same.

Patients were asked later if they would be happier with a smaller or larger incision. Patients were asked to rate the appearance of the scar. All hips were X-rayed and joint motion was measured. Amount of blood lost and time in the operating room were tracked.

The authors report that 100 percent of both groups had good alignment of the hip implants. No differences were measured in the length of hospital stay or problems afterwards. The group with the smaller scar was very pleased with the results. About two-thirds of the group with the longer scar said they would be happier with a smaller incision.

These researchers conclude that a THR can be done safely and effectively with a mini-incision. However, the only real advantage may be the appearance. They advise doctors to use the mini-incision whenever possible to improve patient satisfaction. But they say that appearance shouldn't be more important than a good fit or position of the THR. They are less likely to use the mini-incision on large or overweight patients.

John M. Wright, MD, et al. Mini-Incision for Total Hip Arthroplasty. In The Journal of Arthroplasty. August 2004. Vol. 19. No. 5. Pp. 538-545.

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