Two-incision THA Had Modest Outcomes and Some Substantial Complications

Proponents of two-incision total hip arthroplasty suggest the technique is minimally invasive and promotes rapid rehabilitation with a low prevalence of complications. We applied the two-incision total hip arthroplasty technique to a consecutive group of unselected patients with primary degenerative arthritis to determine the technical difficulty of the operation as measured by the operative time compared with a standard posterior approach, the safety of the operation as measured by the prevalence of complications compared with a standard posterior approach, and the early functional outcome measured by the time to return to activities of daily living as compared with a previous study of the two-incision technique in selected younger patients. The 80 patients included 45 women and 35 men with a mean age of 70.5 years. The patients treated with a two-incision method had longer operative times and substantially more complications than did the patients treated with a standard posterior approach. The early functional outcomes in this group of unselected patients were modest when compared with the previous results in selected younger patients. Patient and surgeon enthusiasm for the potential benefits of the two-incision total hip arthroplasty should be tempered by the modest early outcomes and the substantial prevalence of complications found in this group of typical patients having total hip arthroplasty.

Level of Evidence: Prognostic study, Level III (retrospective study). See the Guidelines for Authors for a complete description of levels of evidence.