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General Orthopaedics

A SYSTEMATIC REVIEW AND META-ANALYSIS OF THE STANDARD VERSUS MINI-INCISION POSTERIOR APPROACH TO TOTAL HIP ARTHROPLASTY

The South West Orthopaedic Club (SWOC) Autumn Meeting



Abstract

The mini-incision posterior approach may appeal to surgeons comfortable with the standard posterior approach to the hip. We present the first systematic review and meta-analysis of these two approaches. Twelve randomised controlled trials and four non-randomised trials comprising of 1498 total hip arthroplasties were included.

The mini-incision posterior approach was associated with an early improvement in Harris hip score of 1.8 points (P < 0.001), reduced operating time (5 minutes, P < 0.001), length of hospital stay (14 hours, P < 0.001), intraoperative and total blood loss (63 ml, P < 0.001 and 119 ml, P < 0.001 respectively). There were no statistically significant differences on the incidence of dislocation, nerve injury, infection or venous thromboembolic events.

The minimally invasive posterior approach appears to provide a safe and acceptable alternative to the standard incision posterior approach.