23rd – 26th AUGUST, 2023
Presenting Author - Sanjeev Patnaik
Minimally invasive surgery has become a trend in the last decade in all aspects of Orthopaedic
surgery, including Total Hip Replacement. The debates and the interest generated in MIS THR is
considerable and several approaches have been advocated. The potential benefits include lower
surgical morbidity, less pain and peri-operative blood loss, quicker rehabilitation, shorter inpatient
stay and improved cosmesis. On the other hand, deficient peer-reviewed literature, a
steep learning curve, increased rate of complications due to inadequate visualization, component
mal-position, neurovascular injuries, dislocation and intra-operative fractures have drawn
criticism. Our present study is a retrospective analysis of early functional and radiological
outcomes of patients undergoing Anterolateral MIS THR between January 2013 and January 2017
. 72 hips of 70 patients were included in the study.. The length of incision , duration of surgery,
peri-operative blood loss, were studied. Functional assessment by Harris Hip Score, pain
assessment by VAS score and radiological assessment for acetabular component and femoral
stem positions were measured on plane X-rays. Data on preoperative and postoperative
hemoglobin and hematocrit values, number of blood transfusions,time to ambulate as well as
duration of hospital stay was studied. We had no major complications in the form of mortality,
fatal Pulmonary embolism , temporary femoral nerve neuropraxia was seen in 1 case, component
mal-position in 3 cases , superficial infection 1 case and a non-displaced proximal femoral fracture
line was evident on the early postoperative X-ray of 1 case. Functional assessment by Harris Hip
Score (HHS )improved from pre-operative 42 (range:26-46) to post-operative 95 (range:72-98) at
1 yr. Radiologic analysis was carried out at post-operative 6 weeks, 3 months,6 months and 1
year. Femoral stem varus alignment was seen in 3 cases, Average Acetabular cup abduction angle
was 43 degrees (range: 40-55 degrees). Average acetabular cup ante-version angle was 17
degrees (range: 12-25 degrees). Of the 72hips, 64 were within the Lewinnek safe zone. The
average postoperative hemoglobin value was 9.7 g/dl ( range: 8.5-12.3 g/dl) and the average
postoperative hematocrit value was 29.8% (range: 28.1-30.6%). The MIS anterolateral approach
allows adequate exposure for component placement, less peri-operative blood loss and pain in
immediate post-op period , earlier discharge from hospital along with early return to function ,
good cosmesis with better patient satisfaction.
Asia Pacific Arthroplasty Society Incorporated