Hip replacement patients discharged sooner after minimally invasive surgery using computer navigation

With minimally invasive hip surgery the surgeon inserts the hip prosthesis through a small incision in the skin, thereby minimizing damage to the muscles and tendons around the hip joint. Computer navigation is used to place the hip prosthesis as precisely as possible. Human movement scientist Inge Reininga of the University Medical Center Groningen has shown that hip replacements can be placed just as precisely using computer navigated minimally invasive hip surgery as with the conventional surgical technique, while reducing the length of hospital stay for patients. Reininga will earn a PhD degree for her research by the University of Groningen on 29 June 2011.

As a result of the ageing population and the increasing incidence of obesity more and more people are suffering from hip osteoarthrits and hence undergo a hip replacement surgery. The surgery is needed to keep them mobile and help them enjoy a healthy, active old age. Surgery that reduces the strain on patients could result in an improvement in medical care. Reininga compared the effectiveness of computer navigated minimally invasive hip surgery with that of the conventional surgical technique.

Reduced length of stay

A group of 35 patients underwent a total hip replacement surgery using the new technique. The results were compared with those of 40 patients who underwent the conventional surgical technique. The average length of stay in hospital was shorter after computer navigated minimally invasive surgery (5.2 days as against 6.9) in spite of a slightly longer operation and greater blood loss.

Gait performance

The hip replacements were placed just as precisely using minimally invasive surgery with computer navigation as with the conventional technique, but no evidence was found that gait performance was restored more quickly after this type of surgery. To ascertain whether hip replacement patients were able to walk just as well again as people with no hip osteoarthritis, their gait function was compared with that of healthy subjects of the same age. Although gait performance was markedly improved after surgery, six months later there were still small differences in certain aspects of gait function between the patients and the healthy subjects.

Incorporation

Reininga recommends incorporating the new minimally invasive surgical technique using computer navigation for hip replacement in reduced-length hospital admission programmes combined with targeted postoperative physiotherapy to promote optimal recovery. Further research is needed into the cost-effectiveness of the new surgical technique compared to the conventional surgical technique.

Curriculum Vitae

Inge Reininga (Marrum, 1981) studied Human Movement Sciences at the University of Groningen. She did her PhD research at the Orthopaedic Department of the UMCG in collaboration with the UMCG’s Health Sciences Department and its Center for Human Movement Sciences. The project is part of the research programme of SHARE, the UMCG’s Graduate School for Health Research. It was funded by the Netherlands Organisation for Health Research and Development. The title of Inge Reininga’s thesis is Computer-navigated minimally invasive total hip arthroplasty. Effectiveness, clinical outcome and gait performance. Supervisors: S.K. Bulstra, J.W. Groothoff. Co-supervisors: M. Stevens, W. Zijlstra