The minimally invasive AMIS technique for total hip replacement : Video article

Abstract

Minimally-invasive implantation of atotal hip arthroplasty without damage to or incision of muscles. Osteoarthritis, femoral neck fracture, general indications for total hip arthroplasty. Contraindications for hip arthroplasty. The surgical technique is demonstrated in detail with the help of avideo of the surgical procedure, which is available online: positioning on afracture table with a special leg holder, anterior approach between tensor fasciae latae and rectus femoris muscle, incision of hip capsule and capsular protection, osteotomy of femoral neck in situ, removal of femoral head and acetabular reaming, minimally invasive implantation of acetabular cup, release of pubofemoral ligament and-if necessary-ischiofemoral ligament, external rotation and hyperextension in leg holder with elevation of the proximal femur by ahypomochlion, femoral preparation and implantation of femoral implant, reposition, capsular suture, wound closure. Weight-bearing as tolerated, free movement without limitation of range of motion. Randomized trials and systematic reviews report faster rehabilitation with early mobilization, within the first 3months after surgery; less postoperative pain, less muscle damage and shorter hospital stay; older patients benefit from reduced morbidity and mortality.