TITLE

Early Pain Relief and Function After Posterior Minimally Invasive and Conventional Total Hip Arthroplasty

AUTHOR(S)
Dorr, Lawrence D.; Maheshwari, Aditya V.; Long, William T.; Zhinian Wan; Sirianni, Leigh Ellen
PUB. DATE
June 2007
SOURCE
Journal of Bone & Joint Surgery, American Volume;Jun2007, Vol. 89-A Issue 6, p1153
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: Few prospective randomized studies have demonstrated benefits of minimally invasive total hip arthroplasty when compared with conventional total hip arthroplasty. We hypothesized that patients treated with a posterior mini-incision would have better results than those treated with a posterior long incision with regard to the achievement of established goals for pain relief and functional recovery permitting hospital discharge by the second postoperative day. Methods: Sixty of 231 eligible patients were randomized (with thirty in each group) to have a total hip arthroplasty performed through either a posterior mini-incision (10 ± 2 cm) or a traditional long incision (20 ± 2 cm). After completion of the total hip arthroplasty, the mini-incision group underwent extension of the skin incision to 20 cm. Patients were evaluated on the basis of self-determined pain scores, requirements for pain medicine, need for assistive gait devices, and time until discharge. Gait analysis provided objective functional assessment. Results: The average hospital stay was 63.2 ± 13.3 hours in the mini-incision group and 73.6 ± 23.5 hours in the long-incision group (p = 0.04). More patients with a mini-incision were discharged by the second postoperative day (p = 0.003) and more were using just a single assistive device at the time of discharge (p = 0.005). As scored on a verbal analog scale of 0 to 10 points, patients with a mini-incision had less pain on each postoperative day and the pain score remained significantly lower at the time of discharge (mean, 2.2 ± 1.0 points compared with 3.1 ± 0.9 points in the long-incision group; p = 0.002). After hospital discharge, there were no clinical differences in pain or function between the two groups of patients. Conclusions: Compared with conventional total hip arthroplasty performed through a posterior incision, posterior minimally invasive total hip arthroplasty resulted in better early pain control, earlier discharge to home, and less use of assistive devices. Subsequent evaluations at six weeks and three months showed equivalency between the clinical results in the two groups. Level of Evidence: Therapeutic Level I. See Instructions to Authors for a complete description of levels of evidence.
ACCESSION #
25315534

 

Related Articles

  • CLINICAL PERFORMANCE OF A DURASUL HIGHLY CROSS-LINKED POLYETHYLENE ACETABULAR LINER FOR TOTAL HIP ARTHROPLASTY AT FIVE YEARS. Dorr, Lawrence D.; Zhinian Wan; Shahrdar, Cambize; Sirianni, Leighellen; Boutary, Myriam; Yun, Andrew // Journal of Bone & Joint Surgery, American Volume;Aug2005, Vol. 87-A Issue 8, p1816 

    Background: Highly cross-linked polyethylene is currently the most common articulation surface used for total hip arthroplasty. The hypothesis of the present study was that the Durasul highly cross-linked polyethylene acetabular liner would have less wear at five years than would a conventional...

  • REVISION OF THE ACETABULAR COMPONENT WITHOUT CEMENT AFTER TOTAL HIP ARTHROPLASTY. Della Valle, Craig J.; Shuaipaj, Tasin; Berger, Richard A.; Rosenberg, Aaron G.; Shott, Susan; Jacobs, Joshua J.; Galante, Jorge O. // Journal of Bone & Joint Surgery, American Volume;Aug2005, Vol. 87-A Issue 8, p1795 

    Abstract: We previously reported our results at a minimum of three and seven years after use of a porous-coated acetabular metal shell in a consecutive series of 138 revision total hip arthroplasties. The current report presents the longer-term outcomes of these procedures, at fifteen to...

  • Usefulness of Histological Analysis for Predicting the Presence of Microorganisms at the Time of Reimplantation After Hip Resection Arthroplasty for the Treatment of Infection. Bori, Guillem; Soriano, Alex; Garcia, Sebastian; Mallofré, Carme; Riba, Josep; Mensa, Josep // Journal of Bone & Joint Surgery, American Volume;Jun2007, Vol. 89-A Issue 6, p1232 

    Background: Appropriate interpretation of a frozen section has a relatively high specificity and sensitivity for the diagnosis of infection when septic loosening of a prosthesis is suspected. However, its usefulness for predicting the presence of microorganisms at the time of reimplantation...

  • Relationship between Patterns of Putting-on and Taking-off Socks and Hip Flexion Range of Motion in Early Stages after Total Hip Arthroplasty Surgery. Nankaku, Manabu; Takagi, Aya; Akiyama, Haruhiko; Goto, Koji; Nakamura, Takashi; Kakinoki, Ryosuke // Rigakuryoho Kagaku;2009, Vol. 24 Issue 2, p241 

    [Purpose] The purpose of this study was to investigate the relationship between patterns of putting-on and taking-off socks and flexion range of total arthroplastic hips in the early postoperative period. [Subjects] The subjects of this study were 74 patients (81 hip joints) who had undergone...

  • Expression of keratan sulfate at the arthroplasty surface after cup arthroplasty. Yamada, Harumoto; Kikuchi, Toshiyuki; Morita, Mitsuhiro; Henmi, Osamu; Fujikawa, Kyosuke; Washimi, Osuke; Terada, Nobuki; Seki, Tsuneo // Archives of Orthopaedic & Trauma Surgery;Jul2000, Vol. 120 Issue 7/8, p473 

    Fibrous tissue which regenerated on the acetabular arthroplasty surface was obtained from a 52-year-old woman who underwent total hip replacement after cup arthroplasty. The histological features of this newly formed fibrous tissue and expression of keratan sulfate, which is a characteristic...

  • THE IMPACT OF INFECTION AFTER TOTAL HIP ARTHROPLASTY ON HOSPITAL AND SURGEON RESOURCE UTILIZATION. Bozic, Kevin J.; Ries, Michael D. // Journal of Bone & Joint Surgery, American Volume;Aug2005, Vol. 87-A Issue 8, p1746 

    Background: Deep infection following total hip arthroplasty is a devastating complication for the patient and a costly one for patients, surgeons, hospitals, and payers. The purpose of this study was to compare revision total hip arthroplasty for infection, revision total hip arthroplasty for...

  • Therapeutic effect of transtrochanteric rotational osteotomy and hip arthroplasty on quality of life of patients with osteonecrosis. Nakai, T.; Masuhara, K.; Matsui, M.; Ohzono, K.; Ochi, T. // Archives of Orthopaedic & Trauma Surgery;May2000, Vol. 120 Issue 5/6, p252 

    We reviewed 37 patients with avascular necrosis of the femoral head (ANF). There were 23 men and 14 women with a mean age of 36 years at the time of the operation. The duration of follow-up was 9 years. Twenty patients had undergone transtrochanteric rotational osteotomy (TRO) and 17, hip...

  • Quality assurance in hip arthroplasty. Effenberger, Harald; Mechtler, Reli; Jerosch, Jörg; Munzinger, Urs; Winter, Thomas // Archives of Orthopaedic & Trauma Surgery;May2000, Vol. 120 Issue 5/6, p308 

    Documentation is key to quality assurance (QA): Data must be complete, plausible, and comparable, and then analyzed to implement corrective measures. Important factors are: qualification of care-providing staff, equipment and implants available (structural quality), effective scheduling of...

  • Bipolar versus total hip endoprosthesis: functional results. Smrke, D.; Beden, Robert; Stankovski, Vlado // Archives of Orthopaedic & Trauma Surgery;May2000, Vol. 120 Issue 5/6, p259 

    Some functional parameters of the hip-joint 3.3 years on average (range 2–8.6 years) after hip arthroplasty are compared with regard to two types of hip endoprostheses: the total (TEP) and the bipolar (BPEP). Flexion, extension, abduction, adduction, and internal and external rotation...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics