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Results of Minimally Invasive Hip Replacement: Too Soon to Tell?

One orthopedic surgeon at the University of Missouri School of Medicine compared two ways of doing total hip replacements (THRs). The first group of 96 patients was operated on using a single mini-incision. With the second group (89 patients) the surgeon used a two-incision approach. All THRs were guided by a special imaging X-ray called fluoroscopy.

The goal of the study was to find out if the results were any different for the two groups. The surgeon went into the study thinking there would not be any more problems with the two-incision method compared to the one mini-incision operation.

The results were quite different from what was expected. There were a very high number of problems after the two-incision operation. Fractures, dislocations, and sinking or loosening of the implant occurred. There were problems with wound healing. One-fourth of the patients had nerve damage.

In this study the rate of complications with the two-incision method of THR decreased as the surgeon did more operations. Many studies say that THR with two-incisions is complex and technically demanding. This is true even with the help of fluoroscopy.

The author suggested if an experienced surgeon who only does joint replacements has such a high rate of complications, it's likely to be even higher for a surgeon with less practice doing joint replacement surgeries.

References: B. Sonny Bal, MD, MBA, et al. Early Complications of Primary Total Hip Replacement Performed with a Two-Incision Minimally Invasive Technique. In The Journal of Bone and Joint Surgery. November 2005. Vol. 87-A. No. 11. Pp. 2432-2438.

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