Short incisions and short stems in total hip arthroplasty

This thesis aims to evaluate the benefits and risks of two already widely implemented innovations in hip arthroplasty: minimally invasive approaches and short stems. In the first part, the amount of soft tissue damage after 5 different hip approaches is compared in a cadaver study, followed by a report of the clinical outcome of a series of patients who received a total hip arthroplasty through a minimally invasive two-incision hip approach. The second part of this thesis starts with a description of some of the challenges in hip implant related trials. The revision rates, as reported in clinical studies, of short stem total hip arthroplasty is summarized in a systematic review. The learning curve of the surgical technique of a short stem hip arthroplasty, the Collum Femoris Preserving (CFP) stem, is analysed through video analysis and pitfalls identified through direct feedback by the surgeons. The thesis is concluded with a report of the functional outcome up to two years of a randomized controlled trial comparing the short curved CFP stem to a straight and longer Zweymuller Alloclassic hip stem.