A two-incision approach: promises and pitfalls.

Abstract

Is this an optimal procedure? Clearly, it is not for every patient, but it does serve patients who can benefit from rapid recovery as well as those patients truly interested in minimizing their down time. It also is clearly not for the occasional total hip surgeon. It is a technique that brings to the patient the maximum potential for speed of recovery. However, it is important to stress again that the surgical approach is just one factor facilitating the recovery curve. While the benefits are real, their importance must be weighed by both surgeon and patient relative to the risks. The risks are not insignificant, but generally decrease with time and experience. As opposed to several smaller incision modifications of routine approaches to THA, the two-incision approach does require a separate and distinctively different skill set, including alternative methods to make up for the lack of standard visualization and careful attention to details such as incision placement and location of the starting point in the intramedullary canal. However, in the rest of the medical world, that is what minimally invasive surgery is about.