[Minimally invasive approaches to the hip joint for total hip arthroplasty: state of the art within the scope of the "OrthoMIT" project for the development of an integrated platform for smart interventional orthopaedic surgery and traumatology]

Abstract

Introduction: Total hip arthroplasty within the field of minimally invasive surgery (MIS) is discussed controversially in the current literature. Potential advantages of MIS should be minimised soft-tissue trauma and thereby less operative loss of blood as well as postoperative pain, resulting in a faster rehabilitation with reduced hospital stay.

Methods: In this article the different minimally invasive approaches to the hip joint for total hip arthroplasty, including anterior, anterolateral, lateral, posterolateral and medial approaches, are reviewed. Potential advantages and disadvantages as well as published results are discussed against the background of evidence-based medicine.

Results: The results available so far on minimally invasive approaches for total hip arthroplasty are almost exclusively extracted from retrospective studies and case series. However, the results of randomised controlled studies in an appreciable number of patients are still lacking.

Conclusion: Minimally invasive approaches to the hip joint have opened a new era in total hip arthroplasty. The current literature does not allow a final judgment about the advantages of MIS in total hip replacement. So far, increasing complications of MIS are reported in the current literature. Until evidence-based data are available, it is strongly recommended that these techniques should only be applied by experienced surgeons.