Strong evidence was found for a decrease in operative time and intraoperative blood loss for MIS THA , with no difference in complication rates and risk for acetabular outliers .
Strong evidence exists that there is no difference in physical functioning , measured either by question naires or by gait analysis .
Moderate evidence was found for a shorter length of hospital stay after MIS THA .
Conflicting evidence was found for a positive effect of MIS THA on pain in the early postoperative period , but that effect diminished after three months postoperatively .
Strong evidence was found for an increase in operative time for CAS THA , and limited evidence was found for a decrease in intraoperative blood loss .
Furthermore , strong evidence was found for no difference in complication rates , as well as for a significantly lower risk for acetabular outliers .
Conclusions The results indicate that MIS THA is a safe surgical procedure , without increases in operative time , blood loss , operative complication rates and component malposition rates .
However , the beneficial effect of MIS THA on functional recovery has to be proven .
The results also indicate that CAS THA , though result ing in an increase in operative time , may have a positive effect on operative blood loss and operative complication rates .
More importantly , the use of CAS results in better positioning of acetabular component of the prosthesis
Background Both minimally invasive surgery ( MIS ) and computer-assisted surgery ( CAS ) for total hip arthroplasty ( THA ) have gained popularity in recent years .
We conducted a qualitative and systematic review to assess the effectiveness of MIS , CAS and computer-assisted MIS for THA .
Early pain relief and function after posterior minimally invasive and conventional total hip arthroplasty. A prospective, randomized, blinded study.
BACKGROUND Few prospect i ve r and omized 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 r and omized ( 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 result ed 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
Strong evidence was found for a decrease in operative time and intraoperative blood loss for MIS THA , with no difference in complication rates and risk for acetabular outliers .
Strong evidence exists that there is no difference in physical functioning , measured either by question naires or by gait analysis .
Moderate evidence was found for a shorter length of hospital stay after MIS THA .
Conflicting evidence was found for a positive effect of MIS THA on pain in the early postoperative period , but that effect diminished after three months postoperatively .
Strong evidence was found for an increase in operative time for CAS THA , and limited evidence was found for a decrease in intraoperative blood loss .
Furthermore , strong evidence was found for no difference in complication rates , as well as for a significantly lower risk for acetabular outliers .
Conclusions The results indicate that MIS THA is a safe surgical procedure , without increases in operative time , blood loss , operative complication rates and component malposition rates .
However , the beneficial effect of MIS THA on functional recovery has to be proven .
The results also indicate that CAS THA , though result ing in an increase in operative time , may have a positive effect on operative blood loss and operative complication rates .
More importantly , the use of CAS results in better positioning of acetabular component of the prosthesis
Background Both minimally invasive surgery ( MIS ) and computer-assisted surgery ( CAS ) for total hip arthroplasty ( THA ) have gained popularity in recent years .
We conducted a qualitative and systematic review to assess the effectiveness of MIS , CAS and computer-assisted MIS for THA .