title: Component position following total hip arthroplasty through a miniinvasive posterolateral approach. Total hip arthroplasty through a minimally invasive lateral approach--our experience and early results. The impact of minimally invasive total hip arthroplasty on the standard procedure Empirical evidence for selective reporting of outcomes in randomized trials: comparison of protocols to published articles. [Minimally invasive total hip arthroplasty with anterior incision]. Comparison of Scars from Total Hip Replacements Done with a Standard or a Mini-incision Rapid Rehabilitation and Recovery with Minimally Invasive Total Hip Arthroplasty A lateral minimal-incision technique in total hip replacement: a prospective, randomizes, controlled trial. Prospective and comparative study of the anterolateral mini-invasive approach versus minimally invasive posterior approach for primary total hip replacement. Early results Mini-incision for total hip arthroplasty: a prospective, controlled investigation with 5-year follow-up evaluation. [A comparison of operative invasiveness in minimally invasive anterolateral hip replacement (MIS-AL) and standard hip procedure, using biochemical markers]. Mini-incision technique for total hip arthroplasty with navigation. Comparison of primary total hip arthroplasties performed with a minimally invasive technique or a standard technique: a prospective and randomized study. Minimally invasive total hip arthroplasty: a prospective randomized study. Early pain relief and function after posterior minimally invasive and conventional total hip arthroplasty. A prospective, randomized, blinded study. Comparison of skin blood flow between mini- and standard-incision approaches during total hip arthroplasty.
abstract: Implant malposition and poor fixation are potential risks of compromising long-term results after total hip arthroplasty performed with a minimally invasive technique . Between September 2000 and February 2002 , 120 cemented primary total hip arthroplasties were performed at the authors ' institutions in patients with primary osteoarthritis of the hip and with BMI lower than 35 . In 60 of these cases selected at r and om , a posterolateral incision no longer than 10 cm was used . The other 60 THA 's were performed through a st and ard posterolateral approach . The inclination and anteversion of the cup and the position of the femoral stem were assessed on radiographs and statistically evaluated . In the miniinvasive group , the average inclination angle of the cup was 42.3 degrees ( range : 36 to 52 degrees ) and the anteversion angle 13.6 degrees ( range : 6 to 29 degrees ) . The coronal alignment of the femoral component was within 3 degrees of neutral in 54 cases ( 90.0 % ) . Following conventional implantation in the other group , the average cup inclination angle was 42.4 degrees ( range : 35 to 50 degrees ) and the anteversion angle 13.6 degrees ( range : 8 to 24 degrees . A total of 53 stems ( 88.3 % ) were implanted optimally . Statistical analysis found no significant difference between the two groups regarding components position . These findings suggest that using a smaller posterolateral incision as was done in this study does not introduce a potential risk of compromising long-term results BACKGROUND AIMS Evaluation of : 1 . early clinical and radiographic results of  total hip arthroplasty ( THA ) through a st and ard lateral direct approach , 2 . early clinical and radiographic results of THA through a minimal lateral approach , 3 . comparison of the results of THA in these two groups . MATERIAL AND METHODS 120 THAs ( 60 cementless and 60 cemented ) done in 120 patients due to degenerative changes were evaluated prospect ively . 60 THAs were done through a minimal lateral approach and constituted a study group . 60 THAs were done through a direct lateral approach and constituted a control group . The mean age of the 120 patients ( 98 women and 22 men ) was 45 y.o . ( range : 32 - 67 y.o . ) . The duration of follow-up in the study group was from 6 to 12 months ( mean : 8.5 months ) . The duration of follow-up in the control group was from 10 to 16 months ( mean : 10.5 months ) . Mean preoperative functional status of the study group was 44.5 points according to the Harris hip score . Radiographic evaluation of the results was done according to the criteria of the Joint Committee of the Hip Society , AAOS and SICOT . RESULTS 6 months after THA , clinical results were 92 pts in the study group and 88 pts in the control group . Radiographic outcomes were very good in all 120 patients from both arms : there were no differences between the control and study group . The incidence of complications was similar in both groups . CONCLUSIONS Minimally invasive THA demonstrated its value in the treatment of  degenerative changes of the hip joint  with regard to short-term outcomes . The clinical and radiographic outcomes were comparable between the st and ard and minimally invasive approaches . Success with THA using a minimally invasive approach depends on excellent operative technique and experience with st and ard hip approaches rather than on the use of special instruments 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 CONTEXT Selective reporting of outcomes within published studies based on the nature or direction of their results has been widely suspected , but direct evidence of such bias is currently limited to case reports . OBJECTIVE To study empirically the extent and nature of outcome reporting bias in a cohort of r and omized trials . DESIGN Cohort study using protocol s and published reports of r and omized trials approved by the Scientific-Ethical Committees for Copenhagen and Frederiksberg , Denmark , in 1994 - 1995 . The number and characteristics of reported and unreported trial outcomes were recorded from protocol s , journal articles , and a survey of trialists . An outcome was considered incompletely reported if insufficient data were presented in the published articles for meta- analysis . Odds ratios relating the completeness of outcome reporting to statistical significance were calculated for each trial and then pooled to provide an overall estimate of bias . Protocol s and published articles were also compared to identify discrepancies in primary outcomes . MAIN OUTCOME MEASURES Completeness of reporting of efficacy and harm outcomes and of statistically significant vs nonsignificant outcomes ; consistency between primary outcomes defined in the most recent protocol s and those defined in published articles . RESULTS One hundred two trials with 122 published journal articles and 3736 outcomes were identified . Overall , 50 % of efficacy and 65 % of harm outcomes per trial were incompletely reported . Statistically significant outcomes had a higher odds of being fully reported compared with nonsignificant outcomes for both efficacy ( pooled odds ratio , 2.4 ; 95 % confidence interval [ CI ] , 1.4 - 4.0 ) and harm ( pooled odds ratio , 4.7 ; 95 % CI , 1.8 - 12.0 ) data . In comparing published articles with protocol s , 62 % of trials had at least 1 primary outcome that was changed , introduced , or omitted . Eighty-six percent of survey responders ( 42/49 ) denied the existence of unreported outcomes despite clear evidence to the contrary . CONCLUSIONS The reporting of trial outcomes is not only frequently incomplete but also biased and inconsistent with protocol s. Published articles , as well as review s that incorporate them , may therefore be unreliable and overestimate the benefits of an intervention . To ensure transparency , planned trials should be registered and protocol s should be made publicly available prior to trial completion OBJECTIVE To report the clinical outcome of minimally invasive total hip arthroplasty  with anterior incision . METHODS One hundred and twenty cases were r and omly divided into two groups . Sixty cases ( group 1 ) who had undergone a mini-invasive THA  were compared with 60 cases ( group 2 ) who had undergone THA with st and ard posterolateral incision .  The operation time , length of incision , blood loss , anteversion angle of acetabulum cup , Harris score and complications were observed . RESULT The average operation time was almost the same ; The average length of incision for group 1 was 7.9 cm ( 7.4 - 9.0 cm ) and 16.3 cm ( 14 - 22 cm ) for group 2 ( P < 0.01 ) . The average blood loss for group 1 was 350 ml ( 250 - 530 ml ) and 650 ml ( 400 - 1200 ml ) for group 2 , there was significant difference between two groups ( P < 0.05 ) . According to the postoperative X-ray , the mean anteversion angles of cup were 24 degrees ( 19 degrees - 27 degrees ) for group 1 and 19 degrees ( 15 degrees - 22 degrees ) for group 2 . The average length of post-operative hospital stay was 7 days ( 5 - 8 days ) in group 1 and 13.5 days ( 12 - 16 days ) in group 2 ( P < 0.05 ) . The Harris score of group 1 was 91.4 ( 67 - 94 ) and 78.5 ( 67 - 91 ) for group 2 at the 3 month follow-up ( P < 0.05 ) . At the last follow up , there were no significant difference ( P > 0.05 ) , but the average ROM of group 1 were definitely more greater than that of group 2 ( 110.0 degrees + /- 3.2 degrees vs. 90.0 degrees + /- 2.9 degrees P < 0.05 ) . There was 1 case of cup reinsertion in group 1 because of large anteversion angle ; 2 cases of symptomatic DVT and 1 case of lethargy because of cerebral infa rct ion happened in group 2 . CONCLUSIONS Minimally invasive total hip arthroplasty using anterior approach is a safe and effective technique with the advantages of less soft tissue damage and less blood loss 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 To assess the potential recovery rate of a  minimally invasive total hip replacement technique  with minimal soft tissue disruption , an accelerated rehabilitation protocol was implemented with weightbearing as tolerated on the day of surgery . One hundred consecutive patients were enrolled in this prospect i ve study . Ninety-seven patients ( 97 % ) met all the inpatient physical therapy goals required for discharge to home on the day of surgery ; 100 % of patients achieved these goals within 23 hours of surgery .  Outpatient therapy  was initiated in 9 % of patients immediately , 62 % of patients by 1 week , and all patients by 2 weeks . The mean time to discontinued use of crutches , discontinued use of narcotic pain medications , and resumed driving was 6 days postoperatively . The mean time to return to work was 8 days , discontinued use of any assistive device was 9 days , and resumption of all activities of daily living was 10 days . The mean time to walk ½ mile was 16 days . Furthermore , there were no readmissions , no dislocations , and no reoperations . Therefore , a rapid rehabilitation protocol is safe and fulfills the potential benefits of a rapid recovery with minimally invasive total hip arthroplasty 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 The interest in minimally invasive approaches for total hip replacement ( THR ) has not waned in any way . We carried out a prospect i ve and comparative study in order to analyse the interest of the anterolateral minimal invasive ( ALMI ) approach in comparison with a minimally invasive posterior ( MIP ) approach .  A group of 35 primary THRs with a large head using the ALMI approach was compared with a group of 43 THR performed through a MIP approach .  The groups were not significantly different with respect to age , sex , bony mass index , ASA score , Charnley class , diagnoses and preoperative Womac index and PMA score . The preoperative Harris Hip Score was significantly lower in the ALMI group . The duration of surgical procedure was longer and the calculated blood loss more substantial in the ALMI group . The perioperative complications were significantly more frequent in this group , with four greater trochanter fractures , three false routes , one calcar fracture , and two metal back bascules versus one femoral fracture in MIP group . Other postoperative data ( implant positioning , morphine consumption , length of hospital stay , type of discharge ) are comparable , such as the early functional results . No other complication has been noted during the first 6 months . The ALMI approach uses the intermuscular interval between the tensor fascia lata and the gluteus medius . It leaves intact the abductor muscles , the posterior capsule and the short external rotators . The early clinical results are excellent , despite the initial complications related to the initial learning curve for this approach and the use of a large head . The stability and the absence of muscular damage should permit acceleration of the postoperative rehabilitation in parallel with less perioperative complications after the initial learning curve . RésuméNous rapportons une étude prospect i ve et comparative de l’abord antéro-latéral mini invasif de la hanche ( AMLI ) pour 35 arthroplasties totales primaires avec tête de gr and diamètre avec l’abord mini invasif postérieur ( MIP ) pour 43 arthroplasties . Les deux groupes n’étaient pas différents selon l’âge , le sexe , l’indice de masse osseuse , le score ASA , la classe de Charnley , le diagnostic , l’index WOMAC et le score de Merle d’Aubigné et Postel . Le score de Harris était plus faible dans le groupe AMLI . La durée opératoire et la perte sanguine calculée étaient plus importantes dans le groupe AMLI . Dans ce même groupe les complications per-opératoires étaient plus fréquentes , avec quatre fractures du gr and trochanter , trois fausses routes , une fracture du calcar , et deux bascules du composant acétabulaire alors qu’il n’y avait qu’une fracture fémorale dans le groupe MIP . Les autres données post-opératoires étaient identiques notamment le résultat fonctionnel précoce . Il n’y avait pas d’autre complication pendant les 6 premiers mois . L’abord antéro-latéral utilise l’intervalle entre le tenseur et le gluteus medius laissant intact les abducteurs , la capsule postérieure et les pelvi-trochantériens . Les résultats cliniques précoces étaient excellents en dépit des complications initiales liées à la courbe d’apprentissage et l’utilisation d’une tête de gr and diamètre . La stabilité et l’absence de dommage musculaire permettaient une récupération post-opératoire plus précoce 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 PURPOSE OF THE STUDY The aim of this prospect i ve r and omized study was to compare , by means of biochemical markers , the operative invasiveness of the st and ard total hip replacement with that of the minimally invasive anterolateral ( MIS-AL ) approach . MATERIAL Twenty-six r and omly assigned patients with st and ard and 22 patients with MIS-AL total hip replacement were included in the study . Patients with elevated pre-operative levels of the markers evaluated or patients taking medication that might affect marker levels were not included . METHODS  Creatine phosphokinase ( CPK ) and C-reactive protein ( CRP ) were chosen as markers of muscle damage and post-operative inflammatory changes , respectively . Blood sample s were drawn before surgery ( less than 24 hours ) and after surgery at 24 , 48 and 96 hours , which respected biological half-lives of the markers and permitted us to study their dynamics . The results were evaluated and statistically analyzed at the department of biochemistry , using the two sample t-test . RESULTS Statistically significant differences between the two groups of patients were found for both markers . The average CRP values differed significantly ( p < 0.05 ) at 48 and 96 hours post-operatively , being higher for the st and ard than MIS-AL total hip replacement by 28 % and 44 % , respectively . The average CPK values showed the most marked difference at 48 hours after surgery , when the level was higher by 62.5 % in the st and ard than MIS-AL total hip replacement ( p < 0.05 ) . DISCUSSION Our objective evaluation of the invasiveness of surgery in total hip replacement was based on the most frequently recommended markers for assessment of muscle tissue damage and post-operative inflammatory changes . The study was focused on the invasiveness of surgery only and neither subjective nor objective outcomes of implantation were evaluated . The use of the muscle sparing approach MIS-AL results in minimal damage to muscle tissue and , consequently , a lower degree of post-operative inflammation than is recorded in traditional hip replacement surgery . CONCLUSIONS In the patients undergoing MIS-AL total hip replacement  , post-operative levels of CPK and CRP were significantly lower than in the patients with st and ard total hip replacement  . The MIS-AL technique evidently provides a more sparing approach to soft tissues 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 The purpose of this prospect i ve r and omized study was to compare the early results of primary total hip arthroplasties performed with a minimally invasive technique or a st and ard technique . A consecutive series of 70 patients who underwent primary bilateral simultaneous total hip arthroplasties was studied . All procedures were performed through a posterolateral approach . Operative times and duration of hemovac drains were significantly shorter in the group with a minimally invasive technique ( P < .05 ) . However , there was a risk of infection when using this technique . There were no any late transfusions in any of our patients postdischarge . This minimally invasive technique did not offer any advantages because the results were not different , and in our h and s , it increased our infection rate 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 BACKGROUND Few prospect i ve r and omized studies have demonstrated benefits of minimally invasive total hip arthroplasty when compared with conventional total hip arthroplasty . We hypothesized that patients treated with a posterior mini-incision would have better results than those treated with a posterior long incision with regard to the achievement of established goals for pain relief and functional recovery permitting hospital discharge by the second postoperative day . METHODS Sixty of 231 eligible patients were r and omized ( with thirty in each group ) to have a total hip arthroplasty performed through either a posterior mini-incision ( 10 + /- 2 cm ) or a traditional long incision ( 20 + /- 2 cm ) . After completion of the total hip arthroplasty , the mini-incision group underwent extension of the skin incision to 20 cm . Patients were evaluated on the basis of self-determined pain scores , requirements for pain medicine , need for assistive gait devices , and time until discharge . Gait analysis provided objective functional assessment . RESULTS The average hospital stay was 63.2 + /- 13.3 hours in the mini-incision group and 73.6 + /- 23.5 hours in the long-incision group ( p = 0.04 ) . More patients with a mini-incision were discharged by the second postoperative day ( p = 0.003 ) and more were using just a single assistive device at the time of discharge ( p = 0.005 ) . As scored on a verbal analog scale of 0 to 10 points , patients with a mini-incision had less pain on each postoperative day and the pain score remained significantly lower at the time of discharge ( mean , 2.2 + /- 1.0 points compared with 3.1 + /- 0.9 points in the long-incision group ; p = 0.002 ) . After hospital discharge , there were no clinical differences in pain or function between the two groups of patients . CONCLUSIONS Compared with conventional total hip arthroplasty performed through a posterior incision , posterior minimally invasive total hip arthroplasty result ed in better early pain control , earlier discharge to home , and less use of assistive devices . Subsequent evaluations at six weeks and three months showed equivalency between the clinical results in the two groups . LEVEL OF EVIDENCE Therapeutic Level Twenty patients who underwent total hip arthroplasty were r and omly allocated to have surgery through a mini incision of < or = 8 cm ( mini-incision surgery [ MIS ] group , n = 10 ) or a st and ard incision of 14 cm ( st and ard group , n = 10 ) . A laser Doppler flowmeter was used to measure the intraoperative blood flow of the skin . The measurements were performed at 2 regions , specifically , anterior and posterior regions across the middle points of skin incision . The measurements were taken before making the incision and after implantation . As a control , the skin blood flow over the anterior superior iliac spine was measured . After implantation , mean skin blood flows at both regions in the MIS group were significantly decreased by 32 % and 33 % . However , the corresponding flows in st and ard group and control regions were constant during operation
target: Operative time and blood loss were significantly reduced in the mini-incision group for studies with the posterior or posterolateral approach .
  Concerning postoperative complications , there were no significant differences between the two groups with no significant heterogeneity .
  No differences were observed between the two groups for Harris hip score and radiographic results except for cup anterversion .
  Although mini-incision appeared to have similar outcomes compared to st and ard incision , the follow-up is short-term according to current st and ards in THA .
  Le temps opératoire et les pertes sanguines étaient significativement moins importants dans le groupe mini-incision réalisé par voie postérieure ou postéro-latérale .
  Il n'y a pas de différence significative dans les complications postopératoires entre les deux groupes de même en ce qui concerne le score de Harris , les résultats radiologiques exceptés pour l'antéversion de la cupule .
background: The purpose of this study was to compare the operative outcome between mini and st and ard incisions in total hip arthroplasty ( THA ) .
  High- quality studies are required to compare the outcomes of these two procedures .ResuméLe but de cette étude est de comparer le devenir opératoire des patients ayant bénéficié d'une prothèse totale de hanche par voie  mini-invasive ou par incision st and ard .