Incision Length Correlates With Patient Weight, Height, and Gender When Using a Minimal-Incision Technique in Total Hip Arthroplasty

Minimal-incision technique in total hip arthroplasty (THA) has been previously defined as requiring an incision of 10 cm or less. A higher complication rate for overweight or muscular patients has been demonstrated when this arbitrary cutoff is used. The purpose of this study was to perform minimal-incision technique surgery without a specific incision length cutoff on a cohort of nonselected, consecutive THA patients to determine if patient height, weight, body mass index, gender, type of femoral fixation, and/or age correlated with incision length. A total of 115 patients underwent THA (posterior approach) using minimal-incision technique by a single, experienced surgeon who performed the smallest incision that was feasible. There was a significant correlation between incision size and patient weight (p < .0001)), height (p D .007), and gender (p D .04). Complications included one patient each with postoperative instability, an intraoperative calcar fracture, and an intraoperative distal incision skin tear. These findings demonstrate that larger patients can expect a longer incision with this technique, and that for a given weight, women will have longer incisions than men. Selecting appropriate incision length for minimally invasive THA reduces potential associated complications. (Journal of Surgical Orthopaedic Advances 17(2):77–81, 2008)