Minimal incision protocols for anesthesia, pain management, and physical therapy with standard incisions in hip and knee arthroplasties: the effect on early outcomes.

Dramatic early outcomes with "minimal incision" surgery are attributed to patient selection, perioperative management, and the surgical procedure. This study was one on 50 patients in a single surgeon's practice who underwent total hip and total knee arthroplasties with standard incisions. The first 25 patients had standard perioperative management, whereas the second 25 had the anesthesia, pain management, and physical therapy protocols described for minimal incision surgery. A dramatic reduction in the time it took to achieve the goals for discharge was observed in the second group. Most patients with the "mini" protocols were ready for discharge within 24 hours. The implications of these results are discussed.