The meta- analysis of the current evidence base showed that minimally invasive THA is associated with a significantly increased risk of transient lateral femoral cutaneous nerve palsy ( p = 0.006 ) with no significantly better outcome
Over the past decade , minimally invasive surgery has gained popularity as a means of optimising early postoperative rehabilitation and increasing patient satisfaction and cosmesis following  total hip arthroplasty ( THA ) .
However , this surgical exposure has also been associated with increased risk of iatrogenic nerve injury and implant mal-positioning due to limited visibility compared to conventionally larger surgical incisions .
The purpose of this meta- analysis was to compare the outcomes of these two surgical exposures .
Minimally invasive total hip replacement via the anterolateral approach in the supine position
Total  hip arthroplasty  through minimally invasive procedures potentially reduces operative trauma , which is expected to result in improved recovery and rehabilitation . We presently perform  total hip arthroplasty  using minimally invasive techniques via an anterolateral modification of the Watson-Jones approach . This approach is performed in the supine position and requires sterile draping of both legs . It also involves a modified operative technique which preserves the pelvitrochanteric muscles and extends the release of the hip capsule . In order to employ a proven implant system ( BICON-PLUS ® threaded cup , SL-PLUS ® stem ) , it was necessary to modify the stem rasps and use manipulation rasps as trial stems . In this report , we compare 50 conventional total hip replacements with 50 procedures performed using the minimally invasive procedure  in terms of blood loss and the duration of the operation . The length of the skin incision varied between 7 and 12 cm with the minimally invasive technique , compared to 15 to 22 cm with the conventional procedure . Both groups were virtually identical with respect to average blood loss ( haemoglobin on 10th post-operative day : minimally invasive group , 108.0 g/L ; conventional group , 112.0 g/L ) and the duration of the procedure ( minimally invasive group , 60 minutes ; conventional group , 58 minutes ) . The position of the implanted components correlated with the pre-operative planning with regard to medial head offset , centre of rotation of the hip , and leg length , and was as satisfactory as that observed with the conventional procedure . The complication rate was low ( 2.9 % ) . Shaft fissures occurred in the first months of use of the minimally invasive procedure before adaptation of the shaft rasps . Dislocations were attributable to improper patient behaviour . Minimally invasive surgery via the anterolateral approach in the supine position was equivalent to the conventional procedure , had a low rate of complications , and did not adversely impact the technical success of the procedure
The meta- analysis of the current evidence base showed that minimally invasive THA is associated with a significantly increased risk of transient lateral femoral cutaneous nerve palsy ( p = 0.006 ) with no significantly better outcome
Over the past decade , minimally invasive surgery has gained popularity as a means of optimising early postoperative rehabilitation and increasing patient satisfaction and cosmesis following  total hip arthroplasty ( THA ) .
However , this surgical exposure has also been associated with increased risk of iatrogenic nerve injury and implant mal-positioning due to limited visibility compared to conventionally larger surgical incisions .
The purpose of this meta- analysis was to compare the outcomes of these two surgical exposures .