Improved Accuracy and Low Fracture and Dislocation Rate with the Two-Incision Total Hip Replacement Technique

We report our early experience with the two-incision hip replacement technique. On the acetabular side, we studied whether a nonoriginating surgeon early in his experience with the minimally invasive two-incision technique for total hip arthroplasty could place components with appropriate accuracy. Thirty-five consecutive hip replacements performed using the two-incision technique were closely matched by height and weight with an equal number of control small-incision arthroplasties. Both leg-length accuracy and abduction angle were significantly superior with the two-incision technique. We also studied our rate of intraoperative femoral calcar or shaft fracture, and early complication rate in 120 two-incision arthroplasties. No displaced shaft or calcar fractures occurred, though two calcar cracks occurred in the first 10, and one nondisplaced shaft split occurred which required no operative treatment. No hip dislocated, and no early infections or femoral or sciatic nerve palsies occurred.

Keywords: Component placement, acetabular abduction position, leg-length position, outcomes