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 .
THE FRANK STINCHFIELD AWARD: Muscle Damage after Total Hip Arthroplasty Done with the Two-incision and Mini-posterior Techniques
Some surgeons have suggested that a minimally invasive two-incision approach allows total hip arthroplasty to be done without cutting or damaging any muscle or tendon . To our knowledge that cl aim has not been supported by any published clinical or basic science data . Our purpose in doing this study was to quantify the extent and location of damage to the abductor and external rotator muscles and tendons after two-incision and mini-posterior total hip arthroplasty .  Ten cadavers ( 20 hips ) were studied . In each cadaver one hip r and omly was assigned to the two-incision group and the contralateral hip was assigned to the mini-posterior group . After inserting the total hip arthroplasty components the muscle damage was assessed using a technique described previously . Damage to the muscle of the gluteus medius and gluteus minimus was substantially greater with the two-incision technique than with the mini-posterior technique . Every two-incision total hip replacement caused measurable damage to the abductors , the external rotators , or both . Every mini-posterior hip replacement caused the external rotators to detach during the exposure and had additional measurable damage to the abductor muscles and tendon . We do not support the contention that a two-incision total hip arthroplasty is done without cutting muscle or tendon . None of the two-incision hip replacements were done without cutting , reaming , or damaging the gluteus medius or gluteus minimus muscle or external rotators
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 .