Skip to main content
Erschienen in: Clinical Orthopaedics and Related Research® 9/2010

01.09.2010 | Symposium: Complications of Hip Arthroplasty

Minimal Incision Surgery as a Risk Factor for Early Failure of Total Hip Arthroplasty

verfasst von: Bradley P. Graw, MD, Steven T. Woolson, MD, Heather G. Huddleston, MD, Stuart B. Goodman, MD, PhD, James I. Huddleston, MD

Erschienen in: Clinical Orthopaedics and Related Research® | Ausgabe 9/2010

Einloggen, um Zugang zu erhalten

Abstract

Background

Minimal incision total hip arthroplasty (MI THA) techniques were developed to decrease postoperative pain and recovery time. Although these techniques have increased in popularity, the long-term survivorship of these procedures is unknown.

Questions/purposes

We therefore investigated whether the time to revision in our referral practice was shorter for patients who underwent primary MI THA compared to primary traditional THA.

Methods

We retrospectively reviewed 46 revision THAs performed during a 3-year period. We excluded revisions performed for infection and rerevisions. Patients with incisions less than or equal to 10 cm were defined as having had MI THA. Fifteen of the 46 patients (33%) had undergone primary MI THA. At the time of primary index THA, the mean ages of the MI and non-MI patients were 65 years and 55 years, respectively.

Results

The mean time to revision was 1.4 years for the MI patients compared with 14.7 years for the non-MI patients. Twelve of the 15 patients having MI THA required revision within 2 years of primary THA compared to 4 of the 31 patients without MI surgery (OR = 26.5, 95% CI 4.4–160.0). There were no differences between the groups with regard to age, gender, or body mass index. The most common reasons for revision in the MI THA group were intraoperative fracture and failure of femoral component osseointegration.

Conclusions

Our data suggest MI THA may be a risk factor for early revision surgery and the long-term survival therefore may be lower than that for non-MI surgery.

Level of Evidence

Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
Literatur
1.
Zurück zum Zitat Bal BS, Haltom D, Aleto T, Barrett M. Early complications of primary total hip replacement performed with a two-incision minimally invasive technique. J Bone Joint Surg Am. 2005;87:2432–2438.CrossRefPubMed Bal BS, Haltom D, Aleto T, Barrett M. Early complications of primary total hip replacement performed with a two-incision minimally invasive technique. J Bone Joint Surg Am. 2005;87:2432–2438.CrossRefPubMed
2.
Zurück zum Zitat Berry DJ, Berger RA, Callaghan JJ, Dorr LD, Duwelius PJ, Hartzband MA, Lieberman JR, Mears DC. Minimally invasive total hip arthroplasty. Development, early results, and a critical analysis. Presented at the Annual Meeting of the American Orthopaedic Association, Charleston, South Carolina, USA, June 14, 2003. J Bone Joint Surg Am. 2003;85:2235–2246.PubMed Berry DJ, Berger RA, Callaghan JJ, Dorr LD, Duwelius PJ, Hartzband MA, Lieberman JR, Mears DC. Minimally invasive total hip arthroplasty. Development, early results, and a critical analysis. Presented at the Annual Meeting of the American Orthopaedic Association, Charleston, South Carolina, USA, June 14, 2003. J Bone Joint Surg Am. 2003;85:2235–2246.PubMed
3.
Zurück zum Zitat Bozic K. Single mini-incision has some perioperative advantages over standard-incision total hip replacement. J Bone Joint Surg Am. 2009;91:1279.CrossRefPubMed Bozic K. Single mini-incision has some perioperative advantages over standard-incision total hip replacement. J Bone Joint Surg Am. 2009;91:1279.CrossRefPubMed
4.
Zurück zum Zitat Bozic KJ, Beringer D. Economic considerations in minimally invasive total joint arthroplasty. Clin Orthop Relat Res. 2007;463:20–25.PubMed Bozic KJ, Beringer D. Economic considerations in minimally invasive total joint arthroplasty. Clin Orthop Relat Res. 2007;463:20–25.PubMed
5.
Zurück zum Zitat Bozic KJ, Kurtz SM, Lau E, Ong K, Vail TP, Berry DJ. The epidemiology of revision total hip arthroplasty in the United States. J Bone Joint Surg Am. 2009;91:128–133.CrossRefPubMed Bozic KJ, Kurtz SM, Lau E, Ong K, Vail TP, Berry DJ. The epidemiology of revision total hip arthroplasty in the United States. J Bone Joint Surg Am. 2009;91:128–133.CrossRefPubMed
6.
Zurück zum Zitat Callaghan JJ, Bracha P, Liu SS, Piyaworakhun S, Goetz DD, Johnston RC. Survivorship of a Charnley total hip arthroplasty. A concise follow-up, at a minimum of thirty-five years, of previous reports. J Bone Joint Surg Am. 2009;91:2617–2621.CrossRefPubMed Callaghan JJ, Bracha P, Liu SS, Piyaworakhun S, Goetz DD, Johnston RC. Survivorship of a Charnley total hip arthroplasty. A concise follow-up, at a minimum of thirty-five years, of previous reports. J Bone Joint Surg Am. 2009;91:2617–2621.CrossRefPubMed
7.
Zurück zum Zitat Chimento GF, Pavone V, Sharrock N, Kahn B, Cahill J, Sculco TP. Minimally invasive total hip arthroplasty. J Arthroplasty. 2005;20:139–144.CrossRefPubMed Chimento GF, Pavone V, Sharrock N, Kahn B, Cahill J, Sculco TP. Minimally invasive total hip arthroplasty. J Arthroplasty. 2005;20:139–144.CrossRefPubMed
8.
Zurück zum Zitat Crowe JF, Sculco TP, Kahn B. Revision total hip arthroplasty: hospital cost and reimbursement analysis. Clin Orthop Relat Res. 2003;413:175–182.CrossRefPubMed Crowe JF, Sculco TP, Kahn B. Revision total hip arthroplasty: hospital cost and reimbursement analysis. Clin Orthop Relat Res. 2003;413:175–182.CrossRefPubMed
9.
Zurück zum Zitat Dorr LD, Maheshwari AV, Long WT, Wan Z, Sirianni LE. 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.CrossRefPubMed Dorr LD, Maheshwari AV, Long WT, Wan Z, Sirianni LE. 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.CrossRefPubMed
10.
Zurück zum Zitat Hungerford DS. Minimally invasive total hip arthroplasty: in opposition. J Arthroplasty. 2004;19(Suppl 1):81–82.CrossRefPubMed Hungerford DS. Minimally invasive total hip arthroplasty: in opposition. J Arthroplasty. 2004;19(Suppl 1):81–82.CrossRefPubMed
11.
Zurück zum Zitat Kim YH. Comparison of primary total hip arthroplasties performed with a minimally invasive technique or a standard technique. J Arthroplasty. 2006;21:1092–1098.CrossRefPubMed Kim YH. Comparison of primary total hip arthroplasties performed with a minimally invasive technique or a standard technique. J Arthroplasty. 2006;21:1092–1098.CrossRefPubMed
12.
Zurück zum Zitat Kurtz SM, Ong KL, Schmier J, Mowat F, Saleh K, Dybvik E, Kärrholm J, Garellick G, Havelin LI, Furnes O, Malchau H, Lau E. Future clinical and economic impact of revision total hip and knee arthroplasty. J Bone Joint Surg Am. 2007;89:144–151.CrossRefPubMed Kurtz SM, Ong KL, Schmier J, Mowat F, Saleh K, Dybvik E, Kärrholm J, Garellick G, Havelin LI, Furnes O, Malchau H, Lau E. Future clinical and economic impact of revision total hip and knee arthroplasty. J Bone Joint Surg Am. 2007;89:144–151.CrossRefPubMed
13.
Zurück zum Zitat Lubowitz JH, Sahasrabudhe A, Appleby D. Minimally invasive surgery in total knee arthroplasty: the learning curve. Orthopedics. 2007;30:80–82.PubMed Lubowitz JH, Sahasrabudhe A, Appleby D. Minimally invasive surgery in total knee arthroplasty: the learning curve. Orthopedics. 2007;30:80–82.PubMed
14.
Zurück zum Zitat Masonis J, Thompson C, Odum S. Safe and accurate: learning the direct anterior total hip arthroplasty. Orthopedics. 2008;31(Suppl 2). Masonis J, Thompson C, Odum S. Safe and accurate: learning the direct anterior total hip arthroplasty. Orthopedics. 2008;31(Suppl 2).
15.
Zurück zum Zitat Mow CS, Woolson ST, Ngarmukos SG, Park EH, Lorenz HP. Comparison of scars from total hip replacements done with a standard or mini-incision. Clin Orthop Relat Res. 2005:441:80–85.CrossRefPubMed Mow CS, Woolson ST, Ngarmukos SG, Park EH, Lorenz HP. Comparison of scars from total hip replacements done with a standard or mini-incision. Clin Orthop Relat Res. 2005:441:80–85.CrossRefPubMed
16.
Zurück zum Zitat Ogonda L, Wilson R, Archbold P, Lawlor M, Humphreys P, O’Brien S, Beverland D. A minimal-incision technique in total hip arthroplasty does not improve early postoperative outcomes: a prospective randomized trial. J Bone Joint Surg Am. 2005;87:701–710.CrossRefPubMed Ogonda L, Wilson R, Archbold P, Lawlor M, Humphreys P, O’Brien S, Beverland D. A minimal-incision technique in total hip arthroplasty does not improve early postoperative outcomes: a prospective randomized trial. J Bone Joint Surg Am. 2005;87:701–710.CrossRefPubMed
17.
Zurück zum Zitat Pagnano MW, Hebl J, Horlocker T. Assuring a painless total hip arthroplasty: a multimodal approach emphasizing peripheral nerve blocks. J Arthroplasty. 2006;21(Suppl 1):80–84.CrossRefPubMed Pagnano MW, Hebl J, Horlocker T. Assuring a painless total hip arthroplasty: a multimodal approach emphasizing peripheral nerve blocks. J Arthroplasty. 2006;21(Suppl 1):80–84.CrossRefPubMed
18.
Zurück zum Zitat Pagnano MW, Trousdale RT, Meneghini RM, Hanssen AD. Slower recovery after two-incision than mini-posterior-incision total hip arthroplasty. A randomized clinical trial. J Bone Joint Surg Am. 2008;90:1000–1006.CrossRefPubMed Pagnano MW, Trousdale RT, Meneghini RM, Hanssen AD. Slower recovery after two-incision than mini-posterior-incision total hip arthroplasty. A randomized clinical trial. J Bone Joint Surg Am. 2008;90:1000–1006.CrossRefPubMed
19.
Zurück zum Zitat Peters CL, Erickson JA, Hines JL. Early results of the Bernese periacetabular osteotomy: the learning curve at an academic medical center. J Bone Joint Surg Am. 2006;88:1920–1926.CrossRefPubMed Peters CL, Erickson JA, Hines JL. Early results of the Bernese periacetabular osteotomy: the learning curve at an academic medical center. J Bone Joint Surg Am. 2006;88:1920–1926.CrossRefPubMed
20.
Zurück zum Zitat Pour AE, Parvizi J, Sharkey PF, Hozack WJ, Rothman RH. Minimally invasive hip arthroplasty: what role does patient preconditioning play? J Bone Joint Surg Am. 2007;89:1920–1927.CrossRefPubMed Pour AE, Parvizi J, Sharkey PF, Hozack WJ, Rothman RH. Minimally invasive hip arthroplasty: what role does patient preconditioning play? J Bone Joint Surg Am. 2007;89:1920–1927.CrossRefPubMed
21.
Zurück zum Zitat Sculco TP. Minimally invasive total hip: in the affirmative. J Arthroplasty. 2004;19(Suppl 1):78–80.CrossRefPubMed Sculco TP. Minimally invasive total hip: in the affirmative. J Arthroplasty. 2004;19(Suppl 1):78–80.CrossRefPubMed
22.
Zurück zum Zitat Seng BE, Berend KR, Ajluni AF, Lombardi AV Jr. Anterior-supine minimally invasive total hip arthroplasty: defining the learning curve. Orthop Clin North Am. 2009;40:343–350.CrossRefPubMed Seng BE, Berend KR, Ajluni AF, Lombardi AV Jr. Anterior-supine minimally invasive total hip arthroplasty: defining the learning curve. Orthop Clin North Am. 2009;40:343–350.CrossRefPubMed
23.
Zurück zum Zitat Wall SJ, Mears SC. Analysis of published evidence on minimally invasive total hip arthroplasty. J Arthroplasty. 2008;23(Suppl 7):55–58.CrossRefPubMed Wall SJ, Mears SC. Analysis of published evidence on minimally invasive total hip arthroplasty. J Arthroplasty. 2008;23(Suppl 7):55–58.CrossRefPubMed
24.
Zurück zum Zitat Woolson ST, Mow CS, Syquia JF, Lannin JV, Schurman DJ. Comparison of primary total hip replacements performed with a standard or a mini-incision. J Bone Joint Surg Am. 2004;86:1353–1358.PubMed Woolson ST, Mow CS, Syquia JF, Lannin JV, Schurman DJ. Comparison of primary total hip replacements performed with a standard or a mini-incision. J Bone Joint Surg Am. 2004;86:1353–1358.PubMed
25.
Zurück zum Zitat Woolson ST, Pouliot MA, Huddleston JI. Primary total hip arthroplasty using an anterior approach and a fracture table. J Arthroplasty. 2009;24:999–1005.CrossRefPubMed Woolson ST, Pouliot MA, Huddleston JI. Primary total hip arthroplasty using an anterior approach and a fracture table. J Arthroplasty. 2009;24:999–1005.CrossRefPubMed
26.
Zurück zum Zitat Wright JM, Crockett HC, Delgado S, Lyman S, Madsen M, Sculco TP. Mini-incision for total hip arthroplasty: a prospective, controlled investigation with 5-year follow-up evaluation. J Arthroplasty. 2004;19:538–545.CrossRefPubMed Wright JM, Crockett HC, Delgado S, Lyman S, Madsen M, Sculco TP. Mini-incision for total hip arthroplasty: a prospective, controlled investigation with 5-year follow-up evaluation. J Arthroplasty. 2004;19:538–545.CrossRefPubMed
Metadaten
Titel
Minimal Incision Surgery as a Risk Factor for Early Failure of Total Hip Arthroplasty
verfasst von
Bradley P. Graw, MD
Steven T. Woolson, MD
Heather G. Huddleston, MD
Stuart B. Goodman, MD, PhD
James I. Huddleston, MD
Publikationsdatum
01.09.2010
Verlag
Springer-Verlag
Erschienen in
Clinical Orthopaedics and Related Research® / Ausgabe 9/2010
Print ISSN: 0009-921X
Elektronische ISSN: 1528-1132
DOI
https://doi.org/10.1007/s11999-010-1300-1

Weitere Artikel der Ausgabe 9/2010

Clinical Orthopaedics and Related Research® 9/2010 Zur Ausgabe

Symposium: Complications of Hip Arthroplasty

Squeaking in Metal-on-Metal Hip Resurfacing Arthroplasties

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Arthroskopie kann Knieprothese nicht hinauszögern

25.04.2024 Gonarthrose Nachrichten

Ein arthroskopischer Eingriff bei Kniearthrose macht im Hinblick darauf, ob und wann ein Gelenkersatz fällig wird, offenbar keinen Unterschied.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Ärztliche Empathie hilft gegen Rückenschmerzen

23.04.2024 Leitsymptom Rückenschmerzen Nachrichten

Personen mit chronischen Rückenschmerzen, die von einfühlsamen Ärzten und Ärztinnen betreut werden, berichten über weniger Beschwerden und eine bessere Lebensqualität.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.