title: Gains and losses of small incision lateral total hip arthroplasty: what the patients want and its index case result.
abstract: OBJECTIVE
  A poll was initially attempted to elucidate what type of skin incision would be preferred by the patients. The retrospective analysis of index cases was preformed to reveal the gains and losses of small incision transgluteal THA.
  
  
  METHODS
  We performed a poll on the preferred type of skin incision to the patients, their families and the medical personnel in orthopedic department in a face-to-face manner. According to the result of the poll, we changed approaches from a standard transgluteal to a small incision transgluteal approach. Each 20 consecutive index patients that underwent standard or small-incision transgluteal THA were followed and compared for more than 2 years.
  
  
  RESULTS
  The small incision THA group showed more rapid mobilization, shorter hospital stay, and better early satisfaction. However, no clinical benefits of small incision were observed after 6-weeks postoperatively. There were significant variations in implant alignments. More early major complications such as dislocation, intraoperative femoral fracture or leg length inequalities occurred in the small incision group.
  
  
  CONCLUSIONS
  The use of a small incision in THA resulted in subtle and temporary gains, at the cost of several major early complications. Now we perform THA with definitely smaller incision than before but we do believe that performing a stable and well-aligned THA is far more important than the length or amount of surgical dissection.
authors.affiliation: Department of Orthopedic Surgery, Kangwon National University Hospital, Chuncheon, South Korea.
authors.forename: Kye Young
authors.initials: KY
authors.lastname: Han
authors.forename: Jonathan P
authors.initials: JP
authors.lastname: Garino
authors.forename: Kee Hyung
authors.initials: KH
authors.lastname: Rhyu
mesh_terms: D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D062109:Dermatologic Surgical Procedures; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D012189:Retrospective Studies