D Wohlrab1, J-W Droege, T Mendel, K Brehme, K Riedl, S Leuchte, W Hein. 1. Zentrum für Erkrankungen der Haltungs- und Bewegungsorgane, Klinik und Poliklinik für Orthopädie, Martin-Luther-Universität Halle-Wittenberg, Halle. david.wohlrab@medizin.uni-halle.de
Abstract
BACKGROUND: The aim of this prospective randomized study was to compare the results after total hip replacement (THR) using an MIS approach versus a regular transgluteal approach (Bauer approach). METHOD: We compared 20 THRs using a modified Watson-Jones minimally invasive approach (MIS group) with 20 conventionally performed THRs using a Bauer approach (control group). In all cases, the same implants (Trilogy cup, MAYO stem) were used. The Harris Hip Score (HHS), the visual analogue scale, myoglobin level, and creatinine kinase level were measured preoperatively and up to 3 months postoperatively. RESULTS: Advantages of the MIS group were evaluated using the HHS in the categories of activity and range of motion 6 weeks postoperatively. In terms of function, gait, and total HHS, we found benefits in the MIS group 6 and 12 weeks postoperatively. Up to 48 h postoperatively, patients in the MIS group had lower myoglobin blood levels. No differences were found in creatinine kinase levels, pain sensation as measured by visual analogue scale, or implant positioning. CONCLUSION: Use of the minimally invasive Watson-Jones approach shows advantages compared with the transgluteal Bauer approach 6 and 12 weeks postoperatively. Up to now there has been no prospective randomized clinical study that has definitely shown the superiority of the minimally invasive procedure. For that reason, the conventional approaches in THR are still the gold standard.
RCT Entities:
BACKGROUND: The aim of this prospective randomized study was to compare the results after total hip replacement (THR) using an MIS approach versus a regular transgluteal approach (Bauer approach). METHOD: We compared 20 THRs using a modified Watson-Jones minimally invasive approach (MIS group) with 20 conventionally performed THRs using a Bauer approach (control group). In all cases, the same implants (Trilogy cup, MAYO stem) were used. The Harris Hip Score (HHS), the visual analogue scale, myoglobin level, and creatinine kinase level were measured preoperatively and up to 3 months postoperatively. RESULTS: Advantages of the MIS group were evaluated using the HHS in the categories of activity and range of motion 6 weeks postoperatively. In terms of function, gait, and total HHS, we found benefits in the MIS group 6 and 12 weeks postoperatively. Up to 48 h postoperatively, patients in the MIS group had lower myoglobin blood levels. No differences were found in creatinine kinase levels, pain sensation as measured by visual analogue scale, or implant positioning. CONCLUSION: Use of the minimally invasive Watson-Jones approach shows advantages compared with the transgluteal Bauer approach 6 and 12 weeks postoperatively. Up to now there has been no prospective randomized clinical study that has definitely shown the superiority of the minimally invasive procedure. For that reason, the conventional approaches in THR are still the gold standard.
Authors: Javad Parvizi; Peter F Sharkey; Aidin Eslam Pour; Venkat Rapuri; William J Hozack; Richard H Rothman Journal: J Arthroplasty Date: 2006-09 Impact factor: 4.757