Process optimized minimally invasive total hip replacement

• Main Authors: Philipp Gebel, Markus Oszwald, Bernd Ishaque, Gaffar Ahmed, Recha Blessing, Fritz Thorey, Andreas Ottersbach
• Format: Article
• Language: English
• Published: Open Medical Publishing 2012-02-01
• Series: Orthopedic Reviews
• Subjects: Total Hip replacement (THR); minimally invasive anterior approach ( DAA); Rotex-Table
• Online Access: http://www.pagepress.org/journals/index.php/or/article/view/3766
• ISSN: 2035-8237; 2035-8164

The purpose of this study was to analyse a new concept of using the the minimally invasive direct anterior approach (DAA) in total hip replacement (THR) in combination with the leg positioner (Rotex- Table) and a modified retractor system (Condor). We evaluated retrospectively the first 100 primary THR operated with the new concept between 2009 and 2010, regarding operation data, radiological and clinical outcome (HOOS). All surgeries were perfomed in a standardized operation technique including navigation. The average age of the patients was 68 years (37 to 92 years), with a mean BMI of 26.5 (17 to 43). The mean time of surgery was 80 min. (55 to 130 min). The blood loss showed an average of 511.5 mL (200 to 1000 mL). No intra-operative complications occurred. The postoperative complication rate was 6%. The HOOS increased from 43 points pre-operatively to 90 (max 100 points) 3 months after surgery. The radiological analysis showed an average cup inclination of 43° and a leg length discrepancy in a range of +/- 5 mm in 99%. The presented technique led to excellent clinic results, showed low complication rates and allowed correct implant positions although manpower was saved.