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Total Hip Replacement: What Do Patients Prefer?

Posted on: 12/28/2006
In the last five years, surgery for total hip replacement (THR) has changed with smaller incisions and minimally invasive surgery (MIS). In this study a direct comparison was made of the two-incision THR and the mini-posterior THR.

The same surgeon did all surgeries. The same anesthesia and rehab program were used with all patients. Twenty-six (26) patients were included. They had the two-incision method done on one hip. Then later they had the mini-posterior approach. Having both hips replaced one after the other is called a staged-bilateral procedure.

After each operation, the patients kept a diary to keep track of their progress. They reported how long they used an assistive device (cane, walker) when walking. They also wrote down when they started driving again and when they went back to work. Other milestones included walking up and down stairs and walking half a mile.

After six months they filled out a survey. They told the researchers which operation they preferred and why. Two-thirds of the patients preferred the mini-posterior THR. Two patients had no preference. The rest liked the two-incision method better. Early recovery, better cosmetic results, or both were named as reasons for the preferences.

The authors report no difference in functional recovery between the two operations. Since the two-incision method is technically more difficult and doesn't have better results or patient preference, surgeons may want to consider using the posterior approach to THR.

Mark W. Pagnano, MD, et al. Patients Preferred a Mini-Posterior THA to a Contralateral Two-Incision THA. In Clinical Orthopaedics and Related Research. December 2006. No. 453. Pp. 156-159.

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