Early discharge and recovery with three minimally invasive total hip arthroplasty approaches: a preliminary study.
Purported advantages of THA performed with minimally invasive surgical approaches include less muscle damage and faster recovery. The purpose of this preliminary investigation was to determine if differences existed between minimally invasive approaches in hospital discharge and early functional recovery in THA patients with a rapid rehabilitation protocol. Twenty-four consecutive patients were randomized to one of three minimally invasive surgical approaches (two-incision, mini-posterior, and mini-anterolateral) and enrolled in an aggressive postoperative rehabilitation program. Hospital discharge, early functional milestone recovery, and validated outcome measures (SF-36, WOMAC, Harris hip score, lower extremity activity scale) were collected. All patients met hospital discharge criteria no later than the first postoperative day. There was no difference in hospital discharge, functional milestone recovery, or validated outcome measures during the first year after surgery with the numbers available. There were no complications directly related to early hospital discharge or the aggressive rehabilitation protocol. While the data suggest earlier hospital discharge and rapid rehabilitation protocols may be implemented successfully we found no difference between the three minimally invasive approaches in early hospital discharge or early functional recovery utilizing a rapid rehabilitation protocol.


METHODS
Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
Meneghini
R Michael
RM
Department of Orthopaedic Surgery, New England Musculoskeletal Institute, University of Connecticut Health Center, Medical Arts and Research Building, 4th Floor, #4016, 263 Farmington Avenue, Farmington, CT 06034-4037, USA. rm_meneghini@yahoo.com
Smits
Shelly A
SA
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D000758:Anesthesia / Q000379:methods; D019644:Arthroplasty, Replacement, Hip / Q000379:methods* / Q000534:rehabilitation*; D005260:Female; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D010351:Patient Discharge / Q000706:statistics & numerical data*; D018579:Patient Selection; D011446:Prospective Studies; D020127:Recovery of Function