Enhanced recovery after posterior minimally invasive total hip arthroplasty with continuous intraarticular anaesthesia

Abstract

Background: The aim of this study was to evaluate the possible complications specific to the continuous intraarticular anaesthesia (CIA) in a minimally invasive posterior approach in total hip arthroplasty and its possible effects on the recovery, especially on pain and the length of hospitalisation. Materials and methods: The surgical procedure is first precisely described step by step with numerous per-operating photographs. Particular technical points are detailed. The errors to be avoided are specified. A prospective series of 70 first-line total hip arthroplasties (one half with and one half without CIA) are analysed for the well-known results of total hip arthroplasty but specifically assessing: (a) specific possible complications to the minimally invasive posterior technique with the prolonged local anaesthesia and (b) effects on pain, duration of hospitalisation and satisfaction in patients (questionnaire). Results: (a) Very low level of immediate post-operative pain was observed in almost all of the patients. (b) Patient satisfaction was high in our series. (c) A repeated education was provided multiple times to avoid specific complications following the absence of pain and consequent inattention. Discussion and conclusion: The minimally invasive posterior approach with continuous intraarticular anaesthesia is an entirely reliable hip arthroplasty procedure. The patients exhibited a significantly less pain and a fast rate of recovery, but preparatory education must be even more significant.