Comparison of Primary Total Hip Replacements Performed with a Standard Incision or a Mini-Incision

Abstract

To The Editor: The study “Comparison of Primary Total Hip Replacements Performed with a Standard Incision or a Mini-Incision” (2004;86:1353-8), by Woolson et al., is probably the quintessential example of comparing apples to oranges because the authors retrospectively compared their standard operation (with which it is assumed they were skilled) and a new operation (with which they were not skilled), without any scientific model, training, instrumentation, or guidance. It was also bad science because they performed a study operation on patients without institutional review board approval. This is the second study from Stanford University published in the last year in which the institutional review board was not involved in surgery that was “experimental.”1 This manuscript is simply an arrogant statement by the authors who assumed that, with fellowship training and more than ten years of experience, they could perform a new operation as well as they perform the operations they have done for all those previous years. There is not a single innovator of the small incision operations who has suggested that these operations are as easy as total hip arthroplasty with use of standard incisions or that they are not more stressful or do not require a learning curve with special instrumentation. At every meeting at which I have participated regarding this … Corresponding author: Steven T. Woolson, MD 1101 Welch Road, Suite C8 Palo Alto, CA 94304 stevewoolson{at}yahoo.com