Round Table Discussion of Mini-incision Total Hip Arthroplasty
Richard Berger: Many different minimally invasive total hip arthroplasty (THA) techniques have become popular in the last few years. Let’s start by defining what is a minimally invasive total hip arthroplasty? Is it a skin incision length, a soft tissue procedure, or a systematic approach to THA?
Andrew Freiberg: As you know, most of us believe that there really is no single approach for a minimally invasive total hip replacement. Moreover, what started as only a surgical approach now has matured to encompass an entire philosophy for patient care that concentrates on rapid recovery. To me, minimally invasive surgery (MIS) can be summarized as a combination of preoperative teaching, anesthesia, pain management and prevention, discharge education and planning, and finally the actual surgical procedure. To answer your question, I think the skin incision length is the least important part of the actual surgical procedure; however, it’s the most visibly definable aspect. Patients’ and their family all key in on incision length, and it really affects how many people feel about the job we performed. I believe that how the hip joint is exposed, minimizing the trauma to the deep tissues by gentle handling, has the greatest impact on early pain and return to function.