Surgical Treatment Of Osteoarthritis Of The Hip: The AMIS Procedure | 45252
Journal of Clinical & Experimental Pathology
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Total Hip Arthroplasty (THA) is the second most common joint replacement procedure performed in the United States, after
primary Total Knee Replacement (TKR). In 2010, more than 300,000 THA procedures were performed. Complications and
revision rates, associated with THA, have declined significantly, despite an increasing number of patients at risk for these outcomes.
Reasons for residual pain after total hip replacement include malalignment of the prosthesis, infection, joint instability, trochanteric
bursitis, heterotopic bone formation, and prosthesis loosening. The large number of approaches for (THA) had increased significantly
the last decades. Transgluteal approach (Hardinge, anterolateral), posterior approach and, recently, anterior approach (AMIS
procedure) are the most favorable among the surgeons. Disadvantages of the transgluteal approach are painful limp due to hip
abductors damage, pain and stiffness due to heterotopic ossification, blood loss and prolonged hospitalization. The anterior access
of the hip was described more than 50 years ago by Robert Judet. These past ten years, several French surgeons, familiar with this
technique, have attempted to reduce the size of skin incision, while preserving the muscles in the same manner. The benefits of
AMIS technique are that no muscle or tendon is cut, there is no inter-nervous plane, and is mostly direct approach with small (5-6
cm) incision (real minimal invasive approach). Most comparative studies give a post-op functional advantage to anterior approach
with the benefit of no blood loss, shorter hospital stay and quicker recovery with 2nd post-op day of full weight bearing. Literature
validated best functional results with very low dislocation rate for AMIS procedure.
Thomas Apostolou is an Orthopedic Spine Surgeon and certified surgeon in AMIS procedures. He has completed his PhD from Aristotle University of Thessaloniki, Greece and Post-doctoral studies from Aristotle University of Thessaloniki, School of Medicine. He is the Director of 3rd orthopedic department of Interbalkan Medical Center of Thessaloniki and Associate Professor of Department of Physiotherapy at Alexander Technological Educational Institute of Thessaloniki. He has published more than 25 papers in reputed journals and has served as Lecturer of Orthopedics, 1st Orthopedic Department, Aristotle University of Thessaloniki, from January 2014 to May 2015.