Differences between minimally invasive and standard techniques for THA?
The traditional/standard technique for THA is a posterior lateral, direct lateral, or anterior approach with an incision that is 6 to 12 inches long. This technique provides good visualization for component placement. The posterior lateral approach and direct lateral approach have a longer recovery time resulting from splitting and dissection of hip musculature (gluteus maximus/external rotators or hip abductors). The posterior approach results in more risk for postoperative hip dislocation (1% to 2%). The anterior approach gains exposure to the hip without detachment of surrounding muscles. Recently, some surgeons have been performing a limited incision technique where the incision is only 4 inches, but the approaches are the same. It is unclear if there is any advantage to this technique other than cosmetic.
The minimally invasive procedure technique involves two small incisions (one anteriorly and one posteriorly) that are each only 1 to 2 inches long. This technique does not split or detach surrounding musculature but requires special training, equipment, and fluoroscopy to perform. Patients undergoing this procedure have less blood loss and quicker recovery times compared with the standard THA procedure. Patients eligible for this procedure must be of normal weight and height, have normal hip anatomy, and can only receive a cementless prosthesis.