Erman CEYHAN, Fatih İNCİ, İbrahim Alper YAVUZ, Utku GÜRHAN, Cahit KOÇAK, İrem YILDIRIM

Minimal İnvaziv Total Kalça Artroplastisi Cerrahisinde İnsizyon Uzunluğu Gerçekten Önemli midir?

Amaç: Bu çalışmanın amacı insizyon uzunluğundaki minimal invaziv tekniklerin standart tekniklere göre üstünlüğünü araştırmaktır. Gereç ve Yöntem: Grup 1 olarak tanımlanan ve minimal invaziv teknikle ameliyat edilen 31 hasta (8 erkek, 23 kadın) ve grup 2 olarak tanımlanan ve standart teknikle ameliyat edilen 42 hasta (11 erkek, 31 kadın) vardı. Kalça fonksiyonu Harris Kalça Puanı (HHS) ile, ağrı Görsel Analog skala (VAS) ve genel fiziksel ve zihinsel durumu Kısa Form - 36 ile değerlendirildi. Bulgular: Grup 1’de ortalama takip süresi 21,8 ay (15-31 ay) ve grup 2’de 58,5 ay (42-75 ay) idi. Ameliyat süresi ve hastanede yatış süresi grup 2’de daha uzun idi (p

Is the Incision Length Really Important in Minimally Invasive Total Hip Replacement Surgery?

Objectives: The aim of this study was to show the superiority of the minimally invasive techniques over standard techniques and any intraoperativechange in incision length.Materials and Methods: There were 31 patients (8 males, 23 females) operated with the minimally invasive technique, who were defined as group1 and 42 patients (11 males, 31 females) operated with a standard technique, who were defined as group 2. The hip function was evaluated withHarris Hip Score (HHS), the pain was evaluated with Visual Analogue Scale (VAS) and general physical and mental status with Short Form (SF) - 36.Results: The mean follow-up period was 21.8 months (15-31 months) in group 1 and 58.5 months (42-75 months) in group 2. The duration ofthe surgery and the duration of hospitalization were longer in group 2 (p

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1. Howell JR, Garbuz DS, Duncan CP. Minimally invasive hip replacement: rationale, applied anatomy, and instrumentation. Orthop Clin North Am. 2004;35:107-118.
2. Lin DH, Jan MH, Liu TK, et al. Effects of anterolateral minimally invasive surgery in total hip arthroplasty on hip muscle strength, walking speed, and functional score. J Arthroplasty. 2007;22:1187-1192.
3. Dorr LD, Maheshwari AV, Long WT, et al. Early pain relief and function after posterior minimally invasive and conventional total hip arthroplasty. A prospective, randomized, blinded study. J Bone Joint Surg Am. 2007;89:1153- 1160.
4. Chimento GF, Pavone V, Sharrock N, et al. Minimally invasive total hip arthroplasty: a prospective randomized study. J Arthroplasty. 2005;20:139- 144.
5. Meneghini RM, Smits SA. Early discharge and recovery with three minimally invasive total hip arthroplasty approaches: a preliminary study. Clin Orthop Relat Res. 2009;467:1431-1437.
6. Mears DC, Mears SC, Chelly JE, et al. THA with a minimally invasive technique, multi-modal anesthesia, and home rehabilitation: factors associated with early discharge? Clin Orthop Relat Res. 2009;467:1412-1417.
7. Bal BS, Haltom D, Aleto T, et al. Early complications of primary total hip replacement performed with a two-incision minimally invasive technique. J Bone Joint Surg Am. 2005;87:2432-2438.
8. Fehring TK, Mason JB. Catastrophic complications of minimally invasive hip surgery: a series of three cases. J Bone Joint Surg Am. 2005;87:711-714.
9. Kim YH. Comparison of primary total hip arthroplasties performed with a minimally invasive technique or a Standard technique: a prospective and randomized study. J Arthroplasty. 2006;21:1092-1098.
10. Graw BP, Woolson ST, Huddleston HG, et al. Minimal incision surgery as a risk factor for early failure of total hip arthroplasty. Clin Orthop Relat Res. 2010;468:2372-2376.
11. Archibeck MJ, White RE Jr. Learning curve for the two incision total hip replacement. Clin Orthop Relat Res. 2004;429:232-238.
12. Khan RJ, Fick D, Khoo P, et al. Less invasive total hip arthroplasty: description of a new technique. J Arthroplasty. 2006;21:1038-1046.
13. Mardones R, Pagnano MW, Nemanich JP, et al. The Frank Stinchfield Award: muscle damage after total hip arthroplasty done with the two-incision and mini-posterior techniques. Clin Orthop Relat Res. 2005;441:63-67.
14. Ciminiello M, Parvizi J, Sharkey PF, et al. Total hip arthroplasty: is small incision better? J Arthroplasty. 2006;21:484-488.
15. Pilot P, Kerens B, Draijer WF, et al. Is minimally invasive surgery less invasive in total hip replacement? A pilot study. Injury. 2006;37:17-23.
16. Goosen JH, Kollen BJ, Castelein RM, et al. Minimally invasive versus classic procedures in total hip arthroplasty: a double-blind randomized controlled trial. Clin Orthop Relat Res. 2011;469:200-208.
17. William M. Mihalko, Mark J. Anders, Quanjun Cui, Thomas Brown, Khaled Saleh. Orthopaedic Surgical Approaches. In: Miller M D (ed). Hip and Pelvis, 1st ed. Saunders, Philadelphia, 2008; p. 395-401.
18. Fitzpatrick TB. The validity and practicality of sun-reactive skin types I through VI. Arch Dermatol. 1988;124:869-871.
19. Shitama T, Kiyama T, Naito M, et al. Minimally invasive versus conventional exposure for total hip arthroplasty: a systematic review and meta-analysis of clinical and radiological outcomes. Int Orthop. 2009;33:1543-1547.
20. Smith TO, Blake V, Hing CB. Which is more invasive-mini versus standard incisions in total hip arthroplasty? Int Orthop. 2011;35:173-184.
21. Pflüger G, Junk-Jantsch S, Schöll V. Minimally invasive total hip replacement via the anterolateral approach in the supine position. Int Orthop. 2007;31:7- 11.
22. DiGioia AM, Plakseychuk AY, Levison TJ, et al. Mini-incision technique for total hip arthroplasty with navigation. J Arthroplasty. 2003;18:123-128.
23. Dutka J, Sosin P, Libura M, et al. Total hip arthroplasty through a minimally invasive lateral approach-our experience and early results. Orthop Traumatol Rehab. 2007;9:39-45.
24. Goebel S, Steinert AF, Schillinger J, et al. Reduced postoperative pain in total hip arthroplasty after minimal-invasive anterior approach. Int Orthop. 2012;36:491-498.
25. Lewinnek GE, Lewis JL, Tarr R. Dislocation after total hip replacement arthroplasties. J Bone Joint Surg. 1978;60:217.
26. DeWal H, Su E, DiCesare PE. Instability following total hip arthroplasty. Am J Orthop. 2003;32:377-382.
27. Padgett DE, Warashina H. The unstable total hip replacement. Clin Orthop Relat Res. 2004;420:72-79.
28. Robbins GM, Masri BA, Garbuz DS, et al. Treatment of hip instability. Orthop Clin North Am. 2001;32:593-610.
29. Siguier T, Siguier M, Bertrand B. Mini-incision anterior approach does not increase dislocation rate. Clin Orthop Relat Res. 2004;426:162-173.
30. Cheng T, Feng JG, Liu T, et al. Minimally invasive total hip arthroplasty: a systematic review. Int Orthop. 2009;33:1473-1481.