Minimal incision techniques can be used for all the main categories of hip prostheses. Although shorter incisions may result in less muscle dissection, they may also reduce visualisation at operation, leading to potential risks that may lead to a higher rate of revisions than might be expected with standard THR.
This health technology assessment concluded that compared with standard total hip replacement, minimal incision THR has small perioperative advantages in terms of blood loss and operation time. It may offer a shorter hospital stay and quicker recovery. There was no evidence of differences in postoperative complication rates and self-reported quality of life. Procedure costs of the two approaches appeared to be similar but evidence on its longer term performance is very limited. Further long-term follow-up data on costs and outcomes including analysis of subgroups of interest to the NHS would strengthen the economic evaluation.
This project was commissioned by the NIHR HTA programme.
Cynthia Fraser; firstname.lastname@example.org
de Verteuil R, Imamura M, Zhu S, Glazener C, Fraser C, Munro N, Hutchison JD, Grant AM, Coyle D, Coyle K, Vale L. Systematic review of the clinical effectiveness and cost-effectiveness and economic modelling of minimal incision total hip replacement approaches in the management of arthritic disease of the hip. Health Technol Assess 2008;12(26):1-244.
Imamura M, Munro NA, Zhu S, Glazener C, Fraser C, Hutchison J, Vale L. Single mini-incision total hip replacement in the management of arthritic disease of the hip: a systematic review and meta-analysis of randomized controlled trials. J Bone Joint Surg Am 2012;94(20):1897-905.