Gains and losses of small incision lateral total hip arthroplasty: what the patients want and its index case result.
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.
Han
Kye Young
KY
Department of Orthopedic Surgery, Kangwon National University Hospital, Chuncheon, South Korea.
Garino
Jonathan P
JP
Rhyu
Kee Hyung
KH
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