Mini Incision Birmingham Hip Resurfacing (BHR) Surgery Lecture - Hena Ziaee, 2007
In this lecture, Hena Ziaee talks about the mini incision approach for Birmingham Hip Resurfacing (BHR) surgery. The approach has been developed by Mr McMinn and it is seen as a more attractive option for patients.
Biomedical Scientist Hena Ziaee BSc (Hons) discusses mini incision surgery used in hip resurfacing procedures. Hip resurfacing can be performed through one of several different approaches. If the procedure can be done safely, the minimal incision approach is more attractive.
Professor Derek McMinn has developed the mini incision approach for this procedure. By its nature, mini incision arthroplasty of the hip is technically more difficult. As well as the surgery technique, the instruments used have also been modified and adapted to aid accessibility and flexibility.
The optimum inclination angle of the acetabular cup is between 40 and 45 degrees. There is only a small margin of error for the positioning of the cup. If the cup angle is too small, the cup is closed and can lead to impingement of the neck. This can lead to cup loosening and implant failure. If the angle is too high, the cup is open, leaving the potential for edge wear which reduces implant survival rate.
A study was carried out to evaluate the technical differences and possible effects of the mini incision and the conventional approach. Acetabular cup inclination and femoral component position results were compared and contrasted. There is a linear relationship between patient body mass index (BMI) and incision length. The incision size has to be longer for larger patients. The mean operating times for both groups were similar. There was no significant difference in blood loss. The length of stay in hospital was longer on average for the traditional approach, at 7.2 days, while the average for mini incision was 5.8 days.
A questionnaire was completed by forty five patients who have had bilateral hip resurfacings. One side was done using the traditional method, whilst the other was done using the mini incision approach. Results lean in favour of mini incision as the shorter skin incision is an attractive option for BHR patients. For surgeons, there is a steep learning curve for this procedure and cup positioning should not be compromised.