Total hip arthroplasty by the technique of OCM / 中华创伤骨科杂志

ABSTRACT

Objective To introduce the technique of OCM hospital (Orthopadische Chirurgie Munchen) in total hip arthroplasty (THA). Methods From January 2005 to January 2006, 20 cases of THA were done in our department with the technique of OCM hospital. The operative approach was through the anterior interval of gluteus medius, and a "V" shaped capsulatomy and a twice-osteotomy of femoral neck were conducted. Specialized acetabular saws and positioners of cup were applied to fix the prosthesis and a table was used to allow the posterior part to be removed. The affected femur was then further externally rotated so that the lower extremity could be placed in the sterilized bag beside the table. In order to achieve better position of the femoral stem, an extensive capsule release was done. Results BMI (body mass index) averaged 27. 4% , the length of skin incision 9. 3 cm, and blood transfusion two units for all the patients. The blood loss and the drainage were 130 mL and 80 mL respectively. In the mean follow up of 4. 3 months, 15 cases recovered completely but five still needed crutches. The mean VAS (visual analog scale) evaluation decreased from the preoperative 5. 1 to 3. 6 (one month later), 1. 7 (three months later ) and 0. 8 (six months later). The mean Harris scores of hip for all the cases increased from the 45. 4 to 88. 4 postoperatively. Conclusions OCM THA owns many advantages, such as small skin incision, less injury to gluteus medius and rapid recovery of patients, but compared with a conventional THA it needs a long learning and special instruments. Its indications are patients who are not over-weighted and have their first THA. Therefore, it is suggested that only qualified hospital and surgeons are allowed to perform the operation.