MicroHip: A Minimally Invasive Procedure for Total Hip Replacement Surgery. A Modified Smith-Peterson Approach.
Journal Title: Ortopedia Traumatologia Rehabilitacja - Year 2007, Vol 9, Issue 1
Abstract
In this article we present the surgical technique of our anterior minimal invasive approach to the hip joint which is aligned along an internerveous plane. This makes it in our view truly minimal invasive. This technique is approached in a lateral decubitus position on a regular operation table, there is no need for a specific orthopaedic- or fracture table. Traction to the leg is not applied, what makes it easy to use on a regular base. Most of the instruments used for this procedure are standard instruments only for reaming of the acetabulum and positioning of the cup specific, angulated instruments are recommended at least for obese patients. Using an incision of not more than 6 to 8cm the the MI surgical approach provides a perfect view of the acetabulum and the proximal femur including the important natural landmarks for adequate implant positioning. The approach follows the interval between the tensor muscle and the gluteaus medius muscle using a section of the anterior ilofemoral approach described by Smith Peterson. No tendons or muscles are cut or detached. The join capsule is split and left in place. The hip joint is not dislocated; we perform the ostheothomy of the femoral neck in situ. To date we have performed several hundred MicroHip operations, and thus far we have never observed any nerve lesions or trochanter fractures. Definitive study results are not as yet available, but our experiences to date show that the method we have developed allows us to operate reliably on virtually any patient. Preliminary results show, that the most of the important factors like hospitalisation time, pain, blood loss and work incapacity can be cut more or less in have. The MicroHip technique is progressively used by more and more different clinics all over the world and can be applied with success from well educated surgeons after a suitable training.
Authors and Affiliations
Markus C. Michel, Pierre Witschger
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