The Mini-incision Direct Lateral Approach in Primary Total Hip Arthroplasty Comparison of early postoperative functional levels following total hip replacement using minimally invasive versus standard incisions. A prospective randomized blinded trial Operative and Patient Care Techniques for Posterior Mini-incision Total Hip Arthroplasty A lateral minimal-incision technique in total hip replacement: a prospective, randomizes, controlled trial. [Advantages of minimal invasive total hip replacement in the early phase of rehabilitation]. Comparison of Scars from Total Hip Replacements Done with a Standard or a Mini-incision Total Hip Arthroplasty through the Mini-Incision (Micro-Hip) Approach versus the Standard Transgluteal (Bauer) Approach: A Prospective, Randomised Study Mini-incision versus mini-incision and computer-assisted surgery in total knee replacement: a radiological prospective randomised study. [Minimally invasive posterior approach for total hip arthroplasty]. A minimal-incision technique in total hip arthroplasty does not improve early postoperative outcomes. A prospective, randomized, controlled trial. Enhanced early outcomes with the anterior supine intermuscular approach in primary total hip arthroplasty. Minimally invasive compared with traditional transgluteal approach for total hip arthroplasty: a comparative gait analysis. Neither pre-operative education or a minimally invasive procedure have any influence on the recovery time after total hip replacement Minimally invasive total hip arthroplasty: a prospective randomized study. Mini-incision technique for total hip arthroplasty with navigation. Mini-incision for total hip arthroplasty: a prospective, controlled investigation with 5-year follow-up evaluation. The impact of minimally invasive total hip arthroplasty on the standard procedure
Patients are inquiring about  mini-incision primary total hip arthroplasty  with increasing frequency . There are no published r and omized controlled trials to substantiate cl aims that the mini-incision direct lateral approach is better than a st and ard approach . The purpose of our study was to review our initial experience with the mini-incision technique through the direct lateral approach , with the intent of implementing a r and omized controlled trial if the approach could be shown as safe and effective . Of importance was determining if there is any difference in component positioning and if there is any difference in intraoperative or postoperative complications between the two groups . We retrospectively compared a consecutive series of 87 primary total hip arthroplasties . Thirty-four total hip arthroplasties were done using a mini-incision direct lateral approach . The mean abduction angle was 45 ° for both groups . The femoral stem alignment was within five degrees of neutral in 97 % of the mini group and 94 % of the st and ard group . There were no dislocations , infections , neurologic or wound complications . There were no differences in medical complications or blood transfusions . A significant decrease was found regarding body mass index , which reflects the bias in patient selection and lack of r and omization . We conclude that it is safe to continue further study with this approach because as there was no increase in complications or component malpositioning . Level of Evidence : Therapeutic study , Level III ( retrospective comparative study ) . See the Guidelines for Authors for a complete description of levels of evidence Objective : To compare the results of single-incision minimally invasive total hip replacement ( ≤ 10 cm ) to st and ard-incision ( 16 cm ) total hip replacement in the early postoperative period with respect to functional and mobilizing ability ( transfers , mobilizing , walking and stair assessment ) . Setting : Orthopaedic wards of a regional orthopaedic centre . Subjects : Two hundred and nineteen total hip replacement patients were tested between December 2003 and June 2004 . Interventions : Patients were r and omized to either total hip replacement through a minimally invasive ( ≤ 10 cm ) or st and ard incision ( 16 cm ) . A single surgeon performed all procedures using the same type of component fixation . Postoperative physiotherapy assessment and treatment was st and ardized . Analgesia was also st and ardized . All patients , physiotherapy staff and assessors were blinded to the incision used . Main outcome measures : Patients were tested two days post operatively and were assessed for the following activities : transfer from supine to sit , transfer from sitting to st and ing , mobilizing , ascending and descending stairs and weight-bearing . Results : The shorter incision offered no significant improvement in patient ability in relation to transfer from lying to sitting , transfer from sitting to st and ing , mobilizing or weight-bearing . Ascending/descending stairs gave a total time for the minimal incision of 38.7 s against 40.8 s for a st and ard incision . There was no difference in walking velocity between the st and ard incision and minimal incision groups two days post operatively ( minimal incision = 0.26 m/s versus st and ard incision = 0.26 m/s ) or six weeks post operatively ( minimal incision = 0.90 m/s versus st and ard incision = 0.93 m/s ) . There was no difference between groups with respect to walking aids at six-week review . The mean length of stay for the minimally invasive approach was 3.65 days ( SD 2.04 ) against 3.68 days ( SD 2.45 ) for the st and ard approach . This was not significantly different . Conclusion : Total hip replacement performed through a minimally invasive incision of ≤ 10 cm compared with a st and ard incision of 16 cm offers no significant benefit in terms of the rate or ability of patients to mobilize and perform functional tasks necessary for safe discharge Technical and patient care improvements have occurred with the posterior mini-incision total hip arthroplasty . We hypothesized that these changes would provide better results for patients . The clinical and radiographic results of 100 total hip arthroplasties done with the posterior mini incision between January 2004 and October 2004 were compared with 100 mini-incision total hip arthroplasties done between December 2001 and September 2002 . There were no differences in diagnosis , age , and body mass index of the patients in each group . Component positions were not compromised in either group . There were improvements in the 2004 group with decreased hospital stay , reduction of postoperative pain and opioid analgesic use , reduced use of assistive devices , and earlier muscle recovery . In the 2004 group there were no complications of infection , dislocation , or sciatic palsy . The posterior mini-incision operation has shown improved results with experience and changes in technique and patient care treatment . Level of Evidence : Therapeutic study , Level IV ( case series ) . See the Guidelines for Authors for a complete description of levels of evidence Minimally invasive surgery has become a trend over the last few years in all aspects of orthopaedic surgery , including total hip arthroplasty . So-called mini-incision techniques involve limiting the length of the skin incision to 10 cm with use of either an anterior , lateral or posterior approach . Between March 2004 and December 2005 one hundred consecutive unilateral total hip replacements were performed by the same senior surgeon in our institute . All patients were r and omly assigned to study group ( group A ) or control group ( group B ) . In group A ( 50 patients ) the  skin incision was 8 cm ; in group B ( 50 patients ) the skin incision was st and ard ( about 12 - 14 cm ) . Patient demographic data , including sex , age , height , weight , BMI , diagnosis and preoperative Harris hip score were recorded . Other criteria evaluated included the perioperative and postoperative complications , the surgical time , the blood loss , the length of the incision , the acetabular and stem positions , the length of hospital stay , Harris Hip Score ( HHS ) and the WOMAC osteoarthritis index at six months . No significant differences were found between the groups with respect to the average surgical time , the acetabular and stem position , the length of hospital stay and the Harris Hip Score ( HHS ) and the WOMAC osteoarthritis index at six months . A significant lower blood loss was found in the mini-incision group . A higher percentage of peri-operative complications was recorded in Group A ( two stupor of sciatic nerve and one fracture of the greater trochanter ) . On the basis of our experience we could speculate that minimally invasive surgery should be directed to the new surgical approach with muscle sparing , instead of a shorter skin incision using st and ard approaches UNLABELLED In arthroplasty the term " minimal invasive " not only refers to the length of the skin incision but more so to its soft tissue and thereby muscle-protecting features . STUDY AIM The aim of this study is to compare the early postoperative mobilisation and rehabilitation of the different surgical approaches in cementless total hip arthroplasty . METHODS 27 patients underwent a total hip replacement ( Trilogy cup , MAYO stem ) via a ventral minimal invasive approach ( one incision technique ) ( MIS group ) . 23 patients underwent a total hip replacement with the same implant via a anterolateral transgluteal approach ( st and ard group ) . We evaluated the Harris Hip Score ( HHS ) , the visual analogue scale ( VAS ) for pain and patient satisfaction preoperatively as well as 3 days , 10 days , 6 weeks and 3 months postoperatively . RESULTS After 3 and 10 days the MIS group showed better scores for pain , gait and mobilisation as well as for the overall HHS compared to the st and ard group . These differences could not be shown 6 weeks postoperatively . The MIS group had a significantly higher rate of complications with 22 % transient impairment of the lateral cutaneous nerve . CONCLUSION The patients of the MIS group showed a better mobilisation and rehabilitation during the early postoperative period . This can be attributed to the lessened intraoperative damage of to soft tissue and especially muscle damage . Due to the increased rate of nerve irritations , we modified our surgical approach . The minimal invasive approach to modern hip joint arthroplasty remains a non-st and ard technique . Compared to the st and ard approach it carries additional risks ( like nerve damage and malpositioning of the implants and thus should remain in the h and s of the experienced orthopaedic surgeon in specialised orthopaedic centres Scar cosmesis is one of the proposed benefits of mini-incision total hip replacement as opposed to st and ard-incision procedures ; however , there has been no scientific proof of this clinical outcome . The cosmetic appearances of healed incisions of 34 primary total hip replacement procedures done by one surgeon using either a mini-incision ( 20 procedures ) or a st and ard-length incision ( 14 procedures ) were compared at an average of 2 years postoperatively . Each scar ’s appearance was grade d independently by two plastic surgeons using a st and ardized rating system . Patients answered a question naire regarding their subjective assessment of their scar . The blinded observers found that more mini-scars ( six of 20 ) were rated poor than st and ard scars ( one of 14 ) and that more st and ard-incision patients had scars that were rated good . More mini-incision patients ( two of 20 versus zero of 14 ) had wound-healing problems . All the patients thought that their hip scar was acceptable in appearance , but 30 of 31 patients rated the relief of pain and total hip replacement longevity as higher priorities than scar cosmesis . The cosmesis of mini-incision total hip replacement scars may be inferior to st and ard-incision scars because of skin and soft tissue damage produced by high retractor pressures needed for exposure using a limited skin incision . Level of Evidence : Therapeutic study , Level II-2 ( prospect i ve comparative study ) . See the Guidelines for Authors for a complete description of levels of evidence Purpose . To compare outcome after  total hip arthroplasty ( THA )  through the mini-incision approach versus the st and ard transgluteal approach . Methods . 80 women and 63 men aged 33 to 89 ( mean , 62 ) years with primary osteoarthritis of the hip were r and omised to undergo unilateral THA through a mini-incision approach ( Micro-hip , n=55 ) or st and ard , lateral , transgluteal approach  ( Bauer , n=88 ) . Levels of haemoglobin , haematocrit , serum creatine kinase , and C-reactive protein , length of hospital stay , mobilisation , and any complication were recorded . Visual analogue scale ( VAS ) for pain was assessed . Hip function was assessed using the Harris Hip Score and the Oxford Hip Score , whereas general health was assessed using the EQ-5D general health question naire . The cup inclination and varus/ valgus of the stem position were measured using a goniometer . Results . The Micro-hip group achieved a significantly lower mean incision length ( 9.3 vs. 13.4 cm , p<0.001 ) , mean surgical time ( 60 vs. 68 minutes , p=0.021 ) , mean reduction in haemoglobin level ( 2.1 vs. 2.8 g/dl , p<0.001 ) , and mean VAS for pain from hour 6 to day 6 ( all p<0.05 ) . One patient in the Micro-hip group developed early aseptic loosening of the cup and underwent revision surgery at month 4 . Three patients in the Bauer group and one patient in the Micro-hip group sustained intra-operative non-displaced fractures of the proximal femur , which were fixed with cerclages . Two patients in the Micro-hip group developed deep vein thrombosis during week 1 . Conclusion . THA through the Micro-hip approach achieved faster pain relief The aim of this trial was to compare the radiological results of 74 patients undergoing a mini-invasive total knee replacement ( TKR ) using either a traditional alignment guide ( MIS group ) or a computer assisted alignment system ( MICA group ) . All the patients were prospect ively r and omised to either group and the same implant was used for both groups . At 8 months post-operatively , the frontal femoral component angle ( FFC ) , the frontal tibial component angle ( FTC ) , the hip-knee-ankle angle ( HKA ) and the sagittal orientation of components ( slopes ) were evaluated respectively . The slopes of the femoral component and the FTC angle were statistically better aligned in the MICA group ( p<0.001 ) . The MICA group showed both a significant fewer number of outliners and a significant higher number of implants with all five radiological parameters ideally aligned . The operative time was statistically longer in the computer assisted group The mini-posterior approach for total hip arthroplasty ( THA )  belongs to the mini-incision approaches . In comparison to st and ard approaches , less muscle trauma result ing in less pain , less blood loss and faster rehabilitation in the early postoperative period are attributed to this approach , as known for all other minimally invasive approaches . In a prospect i ve study of 100 cases of THA it could be shown that this is true when comparing the mini-posterior approach with the posterolateral approach . Lower levels of muscle enzymes as a parameter for muscle trauma , could not be seen BACKGROUND Minimally invasive total hip arthroplasty has stirred substantial controversy with regard to whether it provides superior outcomes compared with total hip arthroplasty performed through longer incisions . The orthopaedic literature is deficient in well- design ed scientific studies to support the clinical superiority of this approach . The objective of this study was to compare the results of a single mini-incision approach with those of a st and ard-incision total hip arthroplasty in the early postoperative period . METHODS Two hundred and nineteen patients ( 219 hips ) admitted for unilateral total hip arthroplasty between December 2003 and June 2004 were r and omized to undergo surgery through a short incision of < or=10 cm or a st and ard incision of 16 cm .  All patients were blinded to the size of the incision for the duration of the hospital stay . The anesthetic , analgesic , and postoperative physiotherapy protocol s were st and ardized , with the staff also blinded to the technique used . A single surgeon , who had performed more than 300 short-incision hip replacements prior to the start of this study and who performs an average of 415 primary total hip replacements a year , performed all procedures through a single-incision posterior approach using a cementless cup and cemented stem . RESULTS The two groups were matched for age , grade according to the system of the American Society of Anesthesiologists , and body mass index . No significant difference was detected with respect to postoperative hematocrit , blood transfusion requirements , pain scores , or analgesic use . We found no difference in early walking ability or length of hospital stay and no difference in component placement , cement-mantle quality , or functional outcome scores at six weeks . The patient variables significantly associated with a probability of early discharge independent of incision length were patient age and preoperative hemoglobin levels ( p < 0.05 ) . The surgical scars contracted significantly over six weeks ( p < 0.05 ) but by a similar proportion of 11 % to 12 % in both groups . CONCLUSIONS Minimally invasive total hip arthroplasty performed through a single-incision posterior approach by a high-volume hip surgeon with extensive experience in less invasive approaches to the hip is safe and reproducible . However , it offers no significant benefit in the early postoperative period compared with a st and ard incision of 16 cm . As it is not known whether lower-volume and less-experienced surgeons can achieve similar results , the mini-incision technique merits further study before wide dissemination and implementation of this family of surgical approaches can be recommended The advantages of minimally invasive surgical approaches for total hip arthroplasty are reported to include reduced blood loss , less pain , and shorter hospital stays , which combine to afford a faster recovery1 - 4 . However , other studies have failed to show any significant advantage over the use of st and ard surgical approaches ( Fig. 1)5 - 8 . Reported disadvantages of minimally invasive techniques are the substantial learning curve required and an increased risk of early complications3,9 - 12 . In addition , the long-term outcomes of minimally invasive procedures in terms of implant fixation and longevity remain unproven . Fig. 1 The st and ard direct lateral approach to the hip previously described by Frndak et al.21 is performed with the patient in the lateral decubitus position . ( Printed with permission of Joint Implant Surgeons , Inc. ) There are three basic categories of so-called minimally invasive total hip arthroplasty approaches : an abbreviated incision ( small incision ) , modifications of st and ard approaches with smaller incisions and less soft-tissue dissection ( less invasive ) , and novel approaches that reportedly do not cut muscle ( minimally invasive ) . We have had a broad experience , over the past seven years , with a less invasive modification of the direct lateral approach ( a modified Hardinge approach ) ( Fig. 2 ) . We previously reported less blood loss and a shorter hospital stay in association with this approach13 . Others have argued that the less invasive direct lateral approach does not provide an advantage over the traditional approach5 . Importantly , the soft-tissue dissection still requires removing and repairing the abductor musculature . Fig. 2 The less invasive direct lateral approach is performed with the patient in the lateral decubitus position . This approach employs an abbreviated skin and fascial incision with a limited abductor muscle dissection13 . ( Printed with permission of Joint Implant Surgeons , Inc. ) Several recent reports have BACKGROUND Minimally invasive total hip arthroplasty is purported to allow an improved and faster rehabilitation in the immediate postoperative period because of reduced soft-tissue damage compared with total hip arthroplasty performed with use of a st and ard approach . In the present study , a minimally invasive approach was compared with a traditional st and ard approach in terms of the effect on gait kinematics as demonstrated with gait analysis and electromyography . METHODS Twenty r and omized patients who underwent a primary total hip replacement with use of a minimally invasive modified Watson-Jones approach ( minimally invasive group ) were compared with a group of twenty patients who underwent a total hip arthroplasty with use of a st and ard transgluteal Hardinge approach ( st and ard group ) . All patients received the same cementless implant , inserted with use of st and ard instruments , and all operations were performed by a single , experienced surgeon . The patients were evaluated with use of three-dimensional gait analysis and dynamic electromyograms at three time points : preoperatively , ten days postoperatively , and twelve weeks postoperatively . Temporospatial and joint-kinematic parameters were evaluated . RESULTS There were no significant differences between the two groups with regard to the temporospatial variables of velocity , cadence , step length , and stride length at any tested time point . With regard to the range of motion of the operatively treated hip , the minimally invasive group had a smaller decrease at the ten-day time point in comparison with the st and ard group . However , this finding was not significant . The reduction in the range of motion was mainly caused by reduced hip extension . A compensatory increase in the pelvic tilt was observed in both groups . One patient in the st and ard group showed a positive Trendelenburg gait ten days postoperatively ; it had disappeared completely at the twelve-week time point . CONCLUSIONS With regard to gait kinematics in the early postoperative period ( three months ) , the present study showed no significant benefit for patients who underwent a total hip arthroplasty through a minimally invasive Watson-Jones approach in comparison with those who were managed with a st and ard transgluteal approach Purpose The purpose of this study was to evaluate pre-operative education versus no education and mini-invasive surgery versus st and ard surgery to reach complete independence . Methods We conducted a four-arm r and omized controlled trial of 209 patients . The primary outcome criterion was the time to reach complete functional independence . Secondary outcomes included the operative time , the estimated total blood loss , the pain level , the dose of morphine , and the time to discharge . Results There was no significant effect of either education ( HR : 1.1 ; P = 0.77 ) or mini-invasive surgery ( HR : 1.0 ; 95 % ; P = 0.96 ) on the time to reach complete independence . The mini-invasive surgery group significantly reduced the total estimated blood loss ( P = 0.0035 ) and decreased the dose of morphine necessary for titration in the recovery ( P = 0.035 ) . Conclusions Neither pre-operative education nor mini-invasive surgery reduces the time to reach complete functional independence .  Mini-invasive surgery significantly reduces blood loss and the need for morphine consumption Patients without prior hip surgery and body mass index lower than 30 undergoing primary total hip arthroplasty were eligible to participate in a r and omized prospect i ve study comparing a minimally invasive with a st and ard approach . The patients were r and omized  to receive incisions  of 8 cm ( group A , n = 28 ) or 15 cm ( group B , n = 32 ) . The groups were similar demographically . Patients in group A had significantly less intraoperative blood loss ( P < .003 ) and less total blood loss ( P < .009 ) . Fewer patients in group A limped at 6 weeks ( P < .04 ) . Operative time , transfusion requirements , narcotic usage , length of hospital stay , achievement of rehabilitation milestones , cane usage , and complications were similar in both groups . There was no difference between the groups at 1- and 2-year follow-up . Compared with a st and ard incision , patients who underwent a minimally invasive total hip arthroplasty demonstrated decreased blood loss and limped less at 6-week follow-up This prospect i ve study compares a mini-incision technique and traditional posterior approach for total hip arthroplasty ( THA ) . Thirty-three patients who had undergone a mini-incision THA were matched by diagnosis , gender , average age , and preoperative Harris Hip Score ( HHS ) to 33 patients who had undergone THA using the traditional posterior approach .  The average length of the incision for group 1 was 11.7 cm ( range , 7.3 - 13.0 ) and for group 2 was 20.2 cm ( range , 14.8 - 26.0 ) . At the 3-month follow-up , patients in the mini-incision group had significant improvement in limp ( P<.05 ) and ability to climb stairs ( P < .01 ) compared with the traditional group . At the 6 month follow-up , the mini-incision group was significantly better in terms of limp ( P < .05 ) , distance walked ( P<.001 ) , and stairs ( P < 0.001 ) . There was no significant difference between groups for pain , function , or range of motion at the 1-year follow-up examination A group of 42 primary total hip arthroplasties performed through an abridged surgical incision ( group 1 ) was prospect ively compared to a cohort of 42 primary total hip arthroplasties performed through a st and ard surgical incision ( group 2 ) . The length of the incision was 8.8 + /- 1.5 cm for group 1 and 23.0 + /- 2.1 cm for group 2 . The groups were not significantly different with respect to age , height , preoperative Harris Hip scores ( HHS ) , estimated blood loss , or length of hospital stay ( P>.05 ) . Group 1 patients had a lower body mass index than group 2 patients ( P<.01 ) . Length of surgery was slightly less for group I ( P = .02 ) . A 0 % incidence was found of infection , nerve palsy , component malposition , and aseptic loosening in both groups . No dislocations occurred in group 1 , and one dislocation occurred in group 2 . Patients in group 1 have expressed considerable enthusiasm regarding the cosmetic appearance of the surgical incisions , and their postoperative HHS are slightly higher than those of group 2 ( P = .042 ) . Total hip arthroplasty can be performed safely and effectively through an abridged surgical incision , but this investigation confirms no dramatic clinical benefit other than cosmetic appeal Minimally invasive total hip arthroplasty  using a short skin incision is a subject of much debate in the literature . The present study estimates the possible minimal length of the exposure in an unselected patient cohort and compares the lateral mini-incision technique and traditional total hip arthroplasty ( THA ) .  One hundred and two patients were divided into three groups according to the type of surgery and length of incision : mini-incision ( less than 10  cm ) was performed in 38 patients ; midi-incision ( 10–14 cm ) in 43 ; and  st and ard-incision ( longer than 14 cm ) in 21 patients . No statistical difference was found with regard to intraoperative and total blood loss , the rate of complications , and postoperative recovery . Significantly decreased body mass index ( BMI ) , shorter operative time , and higher number of hips with malpositioning of the acetabular cup were found in the mini-incision group . These patients , however , experienced less pain in the early postoperative period and were highly satisfied with the cosmetic results . The length of incision was shortened and optimized ( less than 14 cm ) in 82 % of patients , and mini-incision was performed in 38 patients of this unselected cohort . Because of the underst and able dem and of the patients for less invasive intervention , the surgeon should use a smaller but not necessarily mini-incision with minimal soft tissue trauma that still allows him to perform the procedure well , without compromising the type of implants and the otherwise excellent long-term results . R and omized prospect i ve studies are needed to explore the real value of the minimally invasive total hip arthroplasty . RésuméLa chirurgie arthroplastie de la hanche par voie mini invasive est un sujet de débat et de controverse dans la littérature . Cette étude a pour but d’estimer la longueur minimale de la voie d’abord sur une suite de patients non sélectionnés et de comparer la technique de mini incision avec la technique d’incision traditionnelle antérolatérale .  Cent deux patients ont été divisés en trois groupes , en fonction du type de chirurgie et en fonction de la longueur d’incision . Premier groupe : mini incision moins de 10 cm chez 38 patients , deuxième groupe : incision moyenne 10 à 14 cm chez 43 patients et troisième groupe : incision st and ard , supérieure à 14 cm chez 21 patients . Aucune différence statistique n’a été trouvée pour la perte sanguine et sur le taux des complications post-opératoires . Dans le groupe des mini incisions peu de sujets avaient une surcharge pondérale , par contre , il existait un gr and nombre de hanches avec une mal position de la cupule . Ces patients ont cependant présenté moins de douleur dans la période post-opératoire et ont été très satisfaits du résultat cosmétique . La longueur de l’incision dans la chirurgie prothétique de la hanche peut être raccourcie et la longueur optimum peut être de moins de 14 cm chez 82 % des patients . Une mini incision a été réalisé dans cette série , chez 38 patients du fait de la dem and e des patients pour une chirurgie mini invasive , les chirurgiens ont utilisé une petite incision avec un minimum de traumatisme des tissus mous . Cette mini incision doit donc permettre au chirurgien de réaliser son intervention correctement sans compromission sur le type d ’ implants , ni sur la qualité des résultats à long terme . Il n’y a pas besoin pour cela nécessairement d’une mini incision néanmoins des études prospect ives r and omisées doivent être réalisées pour explorer le vrai résultat de la chirurgie arthroplastie par voie mini invasive
Compared with st and ard total hip replacement , mini-incision procedures may have small perioperative advantages in terms of less blood loss , shorter operative time , and shorter inpatient stay , but the differences were not clinical ly important .
Few complications were reported , and the complication rate did not differ significantly between groups .
There was insufficient evidence to suggest any major difference in the short-term revision rate , and confidence intervals for surrogate measures for long-term outcome were broad enough to include clinical ly important differences in favor of either approach .
Although there were marginal short-term advantages and disadvantages for each of the surgical techniques , there was no strong evidence either for or against mini-incision compared with st and ard-incision total hip replacement .
Importantly , evidence on longer-term performance , especially the risk of revision arthroplasty , for mini-incision hip arthroplasty is very limited
BACKGROUND Mini-incision total hip replacement continues the current trend in orthopaedics and other specialties toward smaller-incision surgery .
The purpose of this systematic review was to assess the effectiveness and safety of single mini-incision compared with st and ard-incision total hip replacement for treatment of arthritis of the hip .