|
Minimally invasive hip resurfacing (MIS) is "total or partial hip surgery that can be carried out through an incision of less than 10 cm (3.94 inches) without imparting great forces on the anatomy or compromising component positioning"〔Comis Orthopaedics website〕 The modified posterior MIS approach to hip resurfacing and total hip arthroplasty (hip replacement) displays a host of advantages to the patient: # Less post-operative pain # Less soft tissue damage and pressure on muscle fibres. # Shorter hospital stay # Lower blood loss # Smaller incision # Quicker return to work and functional activities〔Orthopaedic product news, Jan 2008 issue〕 The process of shortening the operative field (mini-incision) for hip resurfacing from the conventional open approach (15–30 cm), to a mini-incision approach (7–15 cm) has been well documented in the realm of hip surgery.〔OPN may issue 2008〕 It has been suggested by some surgeons, however, that in doing this one runs the risk of implanting the components incorrectly, especially the acetabular component.〔McMinn Centre website〕 It has also noted that during femoral head reaming (drilling of the femoral head) with the surgical site being so small, the conventional instruments can damage the soft tissues. Having accepted this, the essential criterion for minimally invasive hip resurfacing are: # An implant designed for MIS delivery # MIS instruments for tissue protection # Specialised instrumentation for femoral neck targeting, acetabular reaming, acetabular impaction and retractors that are soft tissue friendly〔Mr.G.S.Chana, www.minimalinvasivehip.com〕 == History of minimally invasive hip surgery == Minimally invasive techniques for total hip arthroplasty (THA, or hip replacement) have been well described by various authors including: * Richard Berger: "2 incision" technique + fluoroscopy. * Thomas P.Sculco: posterior approach. * Innsbruck (Prof.Nolger): Direct anterior.〔specialistsupersite.com - article entitled "Which approach is better for mini-THA? posterior or 2 incision?"〕 Some MIS approaches for THA have been largely abandoned by surgeons, most especially Richard Berger's approach.〔Mr G.S.Chana, presentation at Fairlawns, Sutton Coldfield, 31 March 2008)〕 None of the above approaches offer a fluoroscopy-free approach to Minimal Invasive Hip Resurfacing. The only documented approach for minimally invasive hip resurfacing, having accepted the definition above, is that of Mr.G.S.Chana〔presentation on MIS resurfacing, Gian Sagar Medical College, India, March 2008〕 of the Royal Orthopaedic Hospital, Birmingham, UK.〔British Orthopaedic Association Handbook 2008〕 Mr.G.S.Chana, the creator of the MIS reamer handle and the Chana Targeting Device has proved that it is possible to perform hip resurfacing through an incision of 6.5 cm's without macerating the soft tissues and incorrectly implanting the acetabular cup.〔 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「Minimally invasive hip resurfacing」の詳細全文を読む スポンサード リンク
|