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Review Article

Med Arch. 2011; 65(4): 246-249


The Experince with Anterior Minimally Invasive Hip Surgery

Mithat Asotic, Predrag Grubor, Sahib Muminagic.

Abstract
Iintroduction. When total hip arthroplasty (THA) is performed, the surgeon has to make a decision about the correct approach. Goals. In this research we will show our first experince with the implantation of endoprothesis for hip, using the method of anterior minimally invasive surgery. Methods. At the Traumatology clinic in Banja Luka, General hospital in Travnik, General hospital „Medicus“ in Jelaha during the period between March 30th 2005 and June 1st 2009 53 hip prosthesis were implanted using minimally invasive Hueter approach, with the average length of incision of 7.3 cm. Subjects were 28 females and 25 males, with an average age of 56.8 years old. The reason for the surgery was hip arthrosis III i IV degree with 48 patients, while two patients had displastic arthrosis. One patient had arthritic changes following non-dislocated fracture of the acetabulum. One patient had arthritic changes of the femur. We implanted 50 non-cemented prosthesis, and tri comined (hybrid) prosthesis. Results. The orthopedic surgery was done with the use of two assistents and operating nurse, within 68 minutes on average while using on average 436 mL of transfused blood. Movements in an upright position with full weight bearing was done on post operative day one with 50 patients. Acute rehabilitation lasted 8.9 days on average. Full recovery was at 50 days on average, with achieved full range of motion and no use of assistive devices. The average Harris Hip Score (HHS) preoperativelly was 56, and three months postoperativelly it was 93. Five patients had complications: two with anterior displocation of the hip, one sealing of the shaft of the femur, and two infections; one superficial and the other deep. Superficial infection was treated with conservative therapy and the other patient had a removal of the prosthesis. Conslusion. Anterior minimally invasive surgery with THA is a method which gives a number of advantages for the patients, such as: lesser extent of operative trauma, shorter hospital stay, and quicker return to activities of daily living.

Key words: anterior minimally invasive surgery, aloplasty of the hip.



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