Abstract
Background
In recent years, the concept of minimally invasive surgery has invaded the orthopaedic
field and literature on the subject is spawning. Mini-incision surgery for total hip
arthroplasty has been studied without a clear consensus on the efficacy, safety and
advantage of that technique. To our knowledge, the efficacy and safety of mini-incisions
in hip fracture surgery has not been studied in a randomised fashion.
Methods
This study is a prospective clinically randomised trial whose primary objective was
to demonstrate the safety and efficacy of a single posterior mini-incision approach
compared to a standard posterior approach for endoprosthesis in acute femoral neck
fractures. The mini-incision was defined as less than 8 cm. 25 patients in the mini-incision surgery (MIS) group and 31 patients in the standard
incision group (STD) were available for analysis. The following validated disease-specific
outcome instruments were used: the Lower Extremity Measurement (LEM) and the Time
Up and Go (TUG). Secondary endpoints of pain, function, and quality of life were assessed
by the components of the Harris Hip Score (HHS) and SF-36. Radiographic outcomes were
also evaluated as well as the rates of all reported complications and adverse events
during the 2 years follow-up.
Results
There was no significant difference for operative time, blood losses, 72 h postoperative haemoglobin as well as the need for transfusion therapy between the
two groups. Also, there was no difference between the groups for postoperative morphine
use and pain evaluation with the Visual Analog Scale. The functional assessment using
LEM and TUG did not demonstrate any statistically significant difference between mini-
and standard incision. However, the HHS and the physical function component of the
SF-36 were statistically better at 2 years in favour of the standard incision group.
Conclusion
Based on the results of the present study, we cannot recommend the use of a minimally
invasive approach over a standard approach in the implantation of a cemented endoprosthesis.
Keywords
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Article info
Publication history
Accepted:
October 2,
2009
Identification
Copyright
© 2009 Published by Elsevier Inc. All rights reserved.
