Publication Date
8-2007
Journal
International Orthopaedics
DOI
10.1007/s00264-007-0432-8
PMID
17665198
PMCID
PMC2267523
PubMedCentral® Posted Date
July 2007
PubMedCentral® Full Text Version
Post-print
Published Open-Access
no
Keywords
Arthroplasty, Replacement, Hip, Biomechanics, Cadaver, Computer Simulation, Fluoroscopy, Humans, Orthopedics, Postoperative Complications, Risk Factors, Surgical Procedures, Minimally Invasive, Treatment Outcome
Abstract
The use of smaller surgical incisions has become popularized for total hip arthroplasty (THR) because of the potential benefits of shorter recovery and improved cosmetic appearance. However, an increased incidence of serious complications has been reported. To minimize the risks of minimally invasive approaches to THR, we have developed an experimental approach which enables us to evaluate risk factors in these procedures through cadaveric simulations performed within the laboratory. During cadaveric hip replacement procedures performed via posterior and antero-lateral mini-incisions, pressures developed between the wound edges and the retractors were approximately double those recorded during conventional hip replacement using Charnley retractors (p < 0.01). In MIS procedures performed via the dual-incision approach, lack of direct visualisation of the proximal femur led to misalignment of broaches and implants with increased risk of cortical fracture during canal preparation and implant insertion. Cadaveric simulation of surgical procedures allows surgeons to measure variables affecting the technical success of surgery and to master new procedures without placing patients at risk.
Comments
PMCID: PMC2267523