Minimally invasive total hip arthroplasty: in the affirmative.

Abstract

Hip arthroplasty can be performed through less invasive exposures and achieve excellent results. The modification of the posterolateral approach is preferred, and in most patients length of skin incision is between 7 and 10 cm. Patient selection is important, and those with body mass index below 28 are the most suitable patients for these procedures. Custom instrumentation is needed to perform these procedures to allow visualization and prevent excessive trauma and traction on the soft tissues. Epidural hypotensive anesthesia and a monoblock acetabular component has facilitated the procedure significantly. In 2 studies, one a randomized trial, blood loss was significantly less and recovery was more rapid. Radiographic measurements of cup and stem position and cement technique were similar to longer, more traditional approaches. The surgeon should be experienced in hip surgery to perform these procedures well and must never compromise hip arthroplasty outcome by these less invasive approaches.