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No Short Cuts to Hip Replacement Surgery

Total hip replacements are usually done with a standard incision at least four inches long. Some surgeons are using a new mini-incision approach. The mini-incision is two anda half inches long or less. This study compares early post-operative results (first six weeks) using both types of incisions.

One surgeon did all the operation (219 hips). He is considered a "high-volume" surgeon. This means he does about 415 total hip replacements (THR) each year. Before starting this study, this surgeon had done at least 300 short-incision THRs.

Does the mini-incision mean less trauma to the soft tissues around the hip? Is there less blood loss? Less pain? Faster recovery? These are the questions doctors tried to answer with this study.

The authors say the mini-incision method is safe when done by an experienced surgeon. But according to the results of this study, a mini-incision doesn't offer any real advantages over the standard incision. There are even some disadvantages with the mini-incision.

The surgeon can't see the hip and structures around the hip as well. There's an increased risk of nerve or blood vessel damage. Problems can also occur if the hip implant doesn't fit properly. This happens when the surgeon doesn't have enough room to work.

Studies like this one must be done before everyone uses a new surgical method. Safety and cost savings must be proven before abandoning the standard incision THR.

References: Luke Ogonda, MRCS, et al. A Minimal-Incision Technique in Total Hip Arthroplasty Does Not Improve Early Postoperative Outcomes. In Journal of Bone and Joint Surgery. April 2005. Vol. 87-A. No. 4. Pp. 701-710.

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