Anterolateral minimally invasive hip approach offered faster rehabilitation with lower complication rates compared to the minimally invasive posterior hip approach-a University clinic case control study of 120 cases.

INTRODUCTION: The surgical approach used in total hip arthroplasty (THA) has been identified as a factor affecting the outcome. In our University Hospital, the posterior surgical approach is the gold standard. The Rottinger approach is an anterolateral approach which is truly minimally invasive, as it does not vertically cut any muscle fibers. The objective of this study was to determine the difference in surgical outcomes between the posterior hip approach and the Rottinger approach which was newly adopted at our Hospital. METHODS: In a retrospective study, a total of 120 patients underwent THA; 60 patients using the Rottinger approach by the young consultant surgeon and another 60 patients using the standard posterior approach by the senior orthopaedic surgeon. Patients have been controlled for age, gender, and ASA grades. All preoperative demographic data showed no significant difference between the control and study groups. The following parameters were analyzed: incision length, duration of the surgery, intraoperative blood loss, WOMAC index, Harris Hip Score, range of motion at 3 and 12 months after surgery, time of quitting the crutches, and willingness for the contralateral hip arthroplasty. RESULTS: WOMAC index, surgical time, and incision lengths have been without significant difference in both approaches. Intraoperative blood loss was significantly lower in the Rottinger group (CI: - 10.903, - 0.064). Harris Hip score was significantly higher (CI: 4.564, 12.973) in the Rottinger group at 3 months, but similar (CI: - 3.484, 2.134) at 12 months follow-up. At 3 months, active flexion and extension were significantly higher in the Rottinger group (CI: 0.595, 8.239; 2.487, 4.480, respectively), and active abduction and passive adduction (CI: - 5.662, - 0.338; - 6.290, - 1.410, respectively) in the posterior approach group. Patients in the Rottinger approach group on average quit crutches 3 weeks earlier and had no postoperative dislocations compared to 2 dislocations in the control group. CONCLUSION: The Rottinger approach offered faster rehabilitation with less need for crutches and with lower complication rates.

ESTABLISHMENT OF THE BONE TISSUE BANK AT MOSTAR UNIVERSITY CLINICAL HOSPITAL.

Bone tissue banks are necessary for collection, production, testing, packaging, storage and delivery of bone transplants. Bone tissue bank is a link between the donor and the recipient by which the donation becomes a medium of health improvement for both the donor and the recipient. At the Department of Orthopedics, Mostar University Clinical Hospital, about 200 total hip replacements are performed per year. Most patients undergoing total hip replacement surgery (90%) have been diagnosed with osteoarthritis, and they are suitable donors, having in mind their age and comorbidities. In the same Department, around 50 procedures that require bone transplants are performed per year. A team of highly competent surgeons are working on an intensive process of adaptation oriented to quality improvement and intensification of the activity, both with the goal of meeting the standards of excellence in orthopedic surgery. The presence of a bone tissue bank has a favorable impact on the quality of health care owing to bone transplant availability, as well as on the scientific role of a highly specialized institution that examines the properties of bone tissue.