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Minimal Incision Total Hip Arthroplasty
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Thomas P. Vail, MD, MBA and John J. Callaghan, MD
Dr. Vail is Professor and Chairman, Department of Orthopaedic Surgery,
University of California, San Francisco, CA. Dr. Callaghan is Lawrence Dorr
Professor of Orthopaedic Surgery, Department of Orthopaedic Surgery, University
of Iowa, Iowa City, IA.
Dr. Vail or a member of his immediate family has received research or
institutional support from DePuy, Zimmer, Smith & Nephew, and Wright Medical,
and has received royalties from DePuy and Zimmer. Dr. Callaghan or a member of
his immediate family has received research or institutional support from DePuy
and has received royalties from DePuy.
Reprint requests: Dr. Vail, Department of Orthopaedic Surgery, University of
California, San Francisco, 500 Parnassus Avenue, MU320 W, San Francisco, CA
94143-0728.
Although debate regarding minimally invasive hip surgery is inconclusive,
information published to date on the risks and benefits of small-incision
approaches focuses the discussion on quality and outcomes. Small-incision
surgical approaches include the posterior, anterolateral, direct anterior, and
two-incision approach. Computer navigation assists in mapping hip replacement
surgery. Obesity is a risk factor and has been found to increase complications.
Patient education, pain management, and rehabilitation are important to recovery
after minimal incision hip arthroplasty.
Total hip replacement may be successfully achieved via smaller incisions,
but functional improvement, discharge to home, patient satisfaction, and
analgesic requirement may be similar regardless of the length of the incision.
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