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The Long and Short of Minimally Invasive Hip Surgery

Does a smaller incision for total hip replacement (THR) mean less blood loss? Shorter surgery time? Shorter hospital stay? Less need for pain relievers? According to this study from Canada, the answer to all these questions is "no."

Sixty patients were included in this study. Thirty had a THR using a minimally invasive (MI) incision. MI means the length of the cut along the skin was less than 10 cm or 2 1/2 inches long. An equal number of patients had the standard length incision (up to 22 cm or six inches long).

Patients in both groups were very similar in terms of number of men and women, age, body size, and type of joint problem. All patients had osteoarthritis of the hip. The operation was the same for both groups, except for the length of the incision. The results of the two groups were compared. The authors report no differences between the groups.

The use of a small incision for THR is not new. Many studies using this approach have been reported. The authors of this report point out the use of the term "minimally invasive" is not the correct term to use if nothing else is different in the way the operation is done.

If the muscles and tendons are cut, it's not minimally invasive. There's no advantage to a small incision when the soft tissue is disrupted. The scar may look better but the patient's recovery time is the same.

The authors conclude cosmetic reasons for a small incision should not replace concern for safety and good results. Minimally invasive should not be confused with minimally disruptive.


Justin de Beer, MD, FRCS(C), et al. Single-Incision, Minimally Invasive Total Hip Arthroplasty: Length Doesn't Matter. In The Journal of Arthroplasty. December 2004. Vol. 19. No. 8. Pp. 945-950.

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