Abstract
The concept of minimally invasive surgery, which refers to percutaneous surgery, i.e. surgery performed through skin orifices without dissection and using arthroscopic instruments, has been misused for hip surgery, which remains a bloody open-focus surgery with direct vision to the implant bone sites. This type of technique, which is characterized by a short incision, is expected to reduce blood loss and postoperative pain, and accelerate functional recovery. These advantages remain theoretical and have never been demonstrated compared to conventional approaches. On the other hand, functional recovery has been significantly improved by a combination of extra-surgical measures including blood saving protocols, postoperative pain control, and shortened hospitalization times. There is no reason why these postoperative optimization protocols should not be generalized to all patients. They take a different form, of course, in scheduled surgery where the patient can be prepared, by correcting the factors of poor prognosis (chronic anemia, withdrawal from addictions, eradication of infectious foci) and in trauma surgery performed in relative urgency. Multidisciplinary management (nutritional, geriatric and functional rehabilitation), particularly in the immediate postoperative period, is necessary to improve the prognosis of this last surgery, which is still too often neglected.
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