Minimally invasive arthroplasty in the management of hip arthritic disease

This review assesses the clinical effects and cost-effectiveness of minimally invasive approaches to THR for arthritis of the hip from the perspective of the Canadian health care system. [...] Economic Analysis Methods: The economic implications of the adoption of MI THR was assessed through a review of existing economic studies and the conduct of a cost-utility analysis comparing MI THR to standard THR. [...] The two-incision technique is performed with the patient supine, and unlike other MI approaches, x- ray fluoroscopy is needed throughout the procedure.3 A short incision is made anterior to the femoral neck and the hip, approached via medial retraction of the sartorius and rectus femoris muscles, and lateral retraction of the tensor fascia lata. [...] In all three randomized studies40,54,55 and most of the non-randomized studies,21,30,53 the intervention and comparison groups were similar at baseline, but this was not the case for one36 and unclear in another.61 Half the studies described the patient eligibility criteria.21,30,36,40 One study reported that the outcome assessor was blinded,36 but no study reported blinding of the care provider o [...] The effect sizes based on the meta-analyses of trial data are summarized in Table 6. It is not possible to make firm conclusions about the two-incision procedure because of the small number of studies identified from our searches and the poor quality of the data reported.