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Thinking Small in Hip Replacement Surgery

Posted on: 10/31/2002
Smaller may be better in joint replacement surgery--smaller incisions, that is. The trend in most joint replacement surgeries is to use the smallest incision possible. The thinking is that smaller cuts do less damage to the surrounding tissues. This can mean fewer complications and quicker recovery.

This study looked at the possible benefits of a type of hip replacement surgery that uses very small incisions. Researchers compared it to a more common type of hip replacement surgery. Both groups got good results from their surgeries. They had about the same rate of complications after surgery and got out of the hospital in about the same amount of time.

But the "mini-incision" group had shorter surgeries. They also had less blood loss and needed fewer blood transfusions during surgery. The mini-incision group walked sooner after surgery and needed less help with moving around. Patients in this group were also less likely to need high levels of nursing care after leaving the hospital.

Researchers tested to see if mini-incision hip replacement worked for obese patients. It seemed to have the same benefits for them. However, the incisions did need to be somewhat larger, and obese patients had more blood less than thinner patients.

The authors emphasize that surgeons need to practice the techniques of mini-incision hip surgery. But clearly, this specific type of mini-incision hip replacement surgery can maximize benefits in the operating room and right after surgery. The senior author now uses mini-incision surgery for all his hip replacements.

James F. Wenz, MD, et al. Mini-Incision Total Hip Arthroplasty: A Comparative Assessment of Perioperative Outcomes. In Orthopedics. October 2002. Vol. 25. No. 10. Pp. 1031-1043.

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