Abstract:

BACKGROUND: There are a variety of surgical approaches for minimally invasive total hip replacement, such as anterolateral, posterolateral and two-incision. However, it is unknown which one is more in line with the concept of minimally invasive and easy to carry out.

OBJECTIVE: To observe the clinical application effect of total hip replacement using anterlateral modified Watson-Jones approach.

METHODS: From January 2005 to December 2006, 35 patients were performed total hip replacement with the new anterlateral approach at the Department of Orthopaedics, the First Affiliated Hospital of Soochow University, including 16 males and 19 females, aged 52-78 years, mean aged 65.9 years; the average body mass index was 24.4 kg/m² (19.3-30.1 kg/m²). The length of incision, operative duration, transfusion, complications, postoperative movement, postoperative hospital stay, prosthesis position and Harris score after operation were observed.

RESULTS AND CONCLUSION: The patients were followed up 6-24 months, with an average of 17.3 months. The average length of incision was 8.3 cm (7-12 cm). The mean operative duration was 92.1 minutes (70-120 minutes). The average blood transfusion was 300 mL (0-800 mL). All the patients were practice their limb muscles immediately after the operation and they were activity the day after operation under the guidance of doctor. The average postoperative hospital stay was 7.9 days (5-15 days). Eleven hip pains occurred at 3 months, 9 cases at 6 months and 5 cases at 12 months, the Harris scores were (79.5±4.4) points, (84.0±3.6) points, and (85.4±3.0) points, respectively. No infection, dislocation, vessel or nerve injury happened. From the follow up, all of the patients had good prosthesis position and rang of hip motion. The results revealed that the new anterolateral approach is minimally invasive total hip replacement, and the patients can recover faster via some proper exercise.