Slower Recovery After Two-Incision Than Mini-Posterior-Incision Total Hip Arthroplasty
Journal of Bone & Joint Surgery, American Volume;May2008, Vol. 90-A Issue 5, p1000
Background: It has been claimed that the two-incision total hip arthroplasty technique provides quicker recovery than other methods do. To date, however, there have been no studies that have directly compared the two-incision technique with another method in similar groups of patients managed with the same advanced anesthetic and rehabilitation protocol. We posed the hypothesis that patients managed with two-incision total hip arthroplasty would recover faster than those managed with mini-posterior-incision total hip arthroplasty and designed a randomized controlled trial specifically (1) to determine if patients recovered faster after two-incision total hip arthroplasty than after mini-posterior- incision total hip arthroplasty as measured on the basis of the attainment of functional milestones that reflect activities of daily living, (2) to determine if the general health outcome after two-incision total hip arthroplasty was better than that after mini-posterior-incision total hip arthroplasty as measured with Short Form-12 (SF-12) scores, and (3) to evaluate the surgical complexity of the two procedures on the basis of the operative time and the prevalence of early complications. Methods: Between November 2004 and January 2006, seventy-two patients undergoing total hip arthroplasty were randomized to two treatment groups: one group was managed with the two-incision technique, and the other group was managed with the mini-posterior-incision technique. The two-incision group comprised thirty-six patients (twenty men and sixteen women) with a mean age of sixty-seven years and mean body mass index of 28.7. The mini-posterior- incision group comprised thirty-six patients (twenty men and sixteen women) with a mean age of sixty-six years and a mean body mass index of 30.2. All patients received the same design of uncemented acetabular and femoral components and were managed with the same comprehensive perioperative pain management and rapid rehabilitation protocol. Operative times and complications were recorded. At two months and one year, all patients were assessed with regard to functional outcome and general health outcome. Results: The patients in the two-incision group recovered more slowly than did those in the mini-posterior-incision group as measured on the basis of the mean time to discontinue a walker or crutches, to discontinue all walking aids, and to return to normal daily activities. The clinical outcome as measured on the basis of the SF-12 scores was similar at both two months and one year postoperatively. The two-incision total hip arthroplasty was a more complex surgical procedure, with a mean operative time that was twenty-four minutes longer; however, the rate of complications (2.8%; one of thirty-six) was the same in the two groups. Conclusions: Our hypothesis that the two-incision technique for total hip arthroplasty would substantially improve the short-term recovery after total hip arthroplasty compared with the mini-posterior incision technique was not proved; instead, the patients managed with the mini-posterior-incision technique had the quicker recovery. Level of Evidence: Therapeutic Level I. See Instructions to Authors for a complete description of levels of evidence.\
- Sport Activity After Total Hip Arthroplasty: Changes in Surgical Technique, Implant Design, and Rehabilitation. Jacobs, Cale A.; Christensen, Christian P.; Berend, Michael E. // Journal of Sport Rehabilitation;Feb2009, Vol. 18 Issue 1, p47
Over the past 10-15 years, many aspects of total hip arthroplasty (THA) have changed. First and foremost, the patients themselves have changed. Since 1990, the age group that has demonstrated the greatest increase in THA was patients between the ages of 45 and 64. As younger, healthier patients...
- The Reliability and Validity of the Self-Reported Patient-Specific Index for Total Hip Arthroplasty. Wright, James G.; Young, Nancy L.; Waddell, James P. // Journal of Bone & Joint Surgery, American Volume;Jun2000, Vol. 82-A Issue 6, p829
Background: The Patient-Specific Index is unique in that it reflects how individual patients weigh concerns in rating the outcome of total hip arthroplasty. The Patient-Specific Index was originally administered by an interviewer, which is not always feasible and can be costly. The purposes of...
- Editorial. Unsworth, Anthony // Proceedings of the Institution of Mechanical Engineers -- Part H;Jan2006, Vol. 220 Issue 1, preceding pi
The article introduces various issues published in the "Journal of Engineering in Medicine," including one on metal-on-hip replacement.
- Kinematics of the Matcoâ„¢ Hip Simulator and Issues Related to Wear Testing of Metal—metal Implants. Medley, J B; Krygier, J J; Bobyn, J D; Chan, F W; Tanzer, M; Lippincott, A // Proceedings of the Institution of Mechanical Engineers -- Part H;1997, Vol. 211 Issue 1, p89
Metalâ€“metal hip implants have been used clinically in Europe to reduce the risk of wear particle induced osteolysis. Joint simulator devices could provide useful information for design improvement of the modern generation of metalâ€“metal hip implants. Early wear results for...
- Metal-on-metal hip resurfacing yields component wear rates similar to modular THR. Brockenbrough, Gina; Owens, Colleen // Orthopaedics Today Europe;May/Jun2011, Vol. 14 Issue 3, p16
The article focuses on a research study which revealed the similarity of the component wear rates of failed metal-on-metal hip resurfacing and modular total hip replacements.
- PERSPECTIVE. Brooks, Peter // Orthopedics Today;Mar2011, Vol. 31 Issue 3, p44
The author comments on the results of a study which show that hip resurfacing has better activity scores and lower revision rates in young patients at mid-term follow-up compared to hybrid total hip replacement.
- Many patients with FAI may benefit from hip arthroscopy. DiMarantonio, Tina // Orthopedics Today;Mar2010, Vol. 30 Issue 3, p28
The article discusses the benefits of hip arthroplasty to patients with femoroacetabular impingement (FAI).
- EUROHIP. // Orthopaedics Today Europe;Sep/Oct2009, Vol. 12 Issue 5, p9
This article features the creation of the EUROHIP project to answer some questions about hip replacement.
- Recommended follow-up visits after cemented THA may not be necessary. Beadling, Lee // Orthopaedics Today Europe;Sep/Oct2009, Vol. 12 Issue 5, p12
This article discusses a study which assessed a recommended schedule for follow-up visits after cemented total hip arthroplasty.
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?