Bandage Surgery for Total Hip ReplacementImagine having a total hip replacement (THR) and going home the same day with just two small bandages on your hip. That's how Dr. Richard A. Berger at St. Luke's Medical Center in Chicago treats some of his patients. In this study, he reports on the results of the first 100 minimally invasive two-incision operations done for THR.
Doctors have been looking for a way to avoid cutting through muscles and tendons during THR. Making such cuts causes pain and slows recovery. Making one cut above and another below the hip to replace the joint is possible now. Specially designed surgical tools and imaging X-rays called fluoroscopy have brought about these changes. New instruments include retractors to pull muscles and tendons away from the area, a special saw to cut away bone, and a special reamer. The reamer is used to make the hole bigger to fit the implant.
Dr. Berger describes step-by-step how it's done from start to finish. He points out the benefits of this method. Besides less trauma to the nearby tissues and less pain, the operation takes less time. The result is cost savings. And patients recover faster.
Very few problems occurred during this 100-patient series. One patient had a broken thighbone during the operation. This was repaired and healed well. At first, patients selected for the operation were thin and had a fairly normal hip shape and size. With practice, the doctor was able to include patients who were obese or who had abnormal hip anatomy. Even patients with hip dislocation or who had surgery before could have this new type of operation.
The author reports good results with this two-incision THR. Someone with special training must do the operation. The method must be practiced many times on cadavers before doing it on live humans. Going home the same day, having less pain, and a faster recovery time make this a favorable option for patients.
Richard A. Berger, MD. Total Hip Arthroplasty Using the Minimally Invasive Two-Incision Approach. In Clinical Orthopaedics and Related Research. December 2003. Vol. 417. Pp. 232-241.
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