Convened under the auspicious of esteemed endorsers - ISTA

Takashi Koyama - Tokyo Medical University - Tokyo, JapanYoichi Katori - Tokyo Medical University - Tokyo, JapanToshinori Masaoka - Tokyo Medical University - Tokyo, JapanTakaaki Shishido - Tokyo Medical University - Tokyo, JapanKengo Yamamoto - Tokyo Medical University - Tokyo, Japan*Email: tateiwa@xf7.so-net.ne.jpObjectives: Since March 2004, we have been performing THA operations using MIS posterolateralapproach. Recently, though, there is an argument that postero-lateral approach withmuscle release should not be considered minimally invasive. This study is to compare MIS-THA with conventional THA which we had performed up until March 2004, and discuss thekey factors in MIS-THA.Patients and Methods: We reviewed 253 patients (278 joints) with coxarthrosis whounderwent cementless THA, including 77 patients (83 joints) who had conventional THA(group C), and 176 patients (195 joints) who had MIS- THA, the method we have started to useaiming for less than 10cm skin incision (group MIS). Group MIS is further classified into twogroups: cases from 2004-2006 (group M1), and from 2007-2008 (group M2).Each group wasevaluated and compared based on the patient’s age, BMI, length of skin incision, operationtime, blood loss, implant placement angle, levels of CRP and CPK, the period up to ambulationand discharge, postoperative infection, and dislocation. In all cases, we used postero-lateralapproach for release and re-suture of short external rotator muscles to greater trochanter.Results: The average length of skin incision of each group was 18.0cm (group C), 9.4cm (groupM1), and 8.7cm (group M2), the average operation time was 105.8 minutes (group C), 83.4minutes (group M1), and 68.4 minutes (group M2), and the average amount of blood loss duringthe surgery was 470.9ml (group C), 374.3ml (group M1), and 339.2ml (group M2). The averageperiod up to ambulation was 9.4 days (group C), 4.9 days (group M1), and 3.2 days (group M2),and the average period up to discharge was 35.7 days (group C), 28.6 days (group M1), and22.9 days (group M2).Postoperative infection or dislocation was found in two cases from groupC, and in one case from group MIS.Discussion: MIS-THA has been firstly reported in 1998, and now became a very commonmethod. In these days, new approaches have been reported, including mini incision, minimallyinvasive, and even more improved approaches without muscle release, such as direct anteriorapproach and antero-lateral approach.We adjust the length of skin incision according to eachcase, make it wide even when it is needed, but surgical invasion has still been minimized yearby year. We think the major factors in MIS are improvement of familiar surgical techniqueswith a better team work, and development in the postoperative management and inrehabilitation procedure, with continuous effort and a will to make a progress.Poster: 106Calcar Bone Graft to Restore Limb Length in ComminutedIntertrochanteric Fractures Treated With Cemented Bipolarfile:///E|/ISTA2010-Abstracts.htm[12/7/2011 3:15:47 PM]