Posterior-lateral approach to minimal incision total hip arthroplasty.
As surgeons learn to perform minimally invasive hip arthroplasty procedures, the various techniques will evolve and one or two approaches may eventually become the standard. Currently, most of these procedures are reserved for the nonmorbidly obese patients; however, as techniques are perfected and surgeons gain experience, this patient population may eventually be served. Surgeons must present information to patients in a responsible manner and clarify the actual versus perceived advantages of the MITH. It is unfortunate that some patients may abandon an experienced surgeon (who will likely give an excellent long-term clinical outcome) for an inexperienced surgeon who can provide a smaller incision (with long-term benefits thus far unknown). Surgeons must also address the same comorbidities and complications for MITH arthroplasty as with the conventional approaches such as DVT, fat embolism, pain control, and wound healing. Routines for postoperative care and screening for complications must remain within the plan of care for the standard incision and MITH patient.information to patients in a responsible manner and clarify the actual versus perceived advantages of the MITH. It is unfortunate that some patients may abandon an experienced surgeon (who will likely give an excellent long-term clinical outcome) for an inexperienced surgeon who can provide a smaller incision (with long-term benefits thus far unknown). Surgeons must also address the same comorbidities and complications for MITH arthroplasty as with the conventional approaches such as DVT, fat embolism, pain control, and wound healing. Routines for postoperative care and screening for complications must remain within the plan of care for the standard incision and MITH patient.
Goldstein
Wayne M
WM
University of Illinois at Chicago, Illinois Bone and Joint Institute, 2454 Dempster Street, Suite 206, Des Plaines, IL 60016, USA. wmgibji@aol.com
Branson
Jill J
JJ
D000077:Acetabulum / Q000601:surgery; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000379:methods*; D062109:Dermatologic Surgical Procedures; D005269:Femur / Q000601:surgery; D006801:Humans; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects / Q000379:methods; D010347:Patient Care Planning; D011183:Postoperative Complications; D018570:Risk Assessment; D016896:Treatment Outcome