There is still controversy as to whether minimally invasive total hip arthroplasty enhances the postoperative outcome. The aim of this study was to compare the outcome of patients who underwent total hip replacement through an anterolateral minimally invasive (MIS) or a conventional lateral approach (CON). We performed a randomized, prospective study of 75 patients with primary hip arthritis, who underwent hip replacement through the MIS (n=36) or CON (n=39) approach. The Western Ontario and McMaster Universities Osteoarthritis Index and Harris Hip score (HHS) were evaluated at frequent intervals during the early postoperative follow-up period and then after 3.5 years. Pain sensations were recorded. Serological and radiological analyses were performed. In the MIS group the patients had smaller skin incisions and there was a significantly lower rate of patients with a positive Trendelenburg sign after six weeks postoperatively. After six weeks the HHS was 6.85 points higher in the MIS group (P=0.045). But calculating the mean difference between the baseline and the six weeks HHS we evaluated no significant differences. Blood loss was greater and the duration of surgery was longer in the MIS group. The other parameters, especially after the twelfth week, did not differ significantly. Radiographs showed the inclination of the acetabular component to be significantly higher in the MIS group, but on average it was within the same permitted tolerance range as in the CON group. Both approaches are adequate for hip replacement. Given the data, there appears to be no significant long term advantage to the MIS approach, as described in this study.

In production processes uncertainty has a great impact on the product quality as well as production costs. In automotive industry the reaming of valve guides in a cylinder head of a combustion engine is a quality determining process. Due to the force fitting of the valve guides into the cylinder head the final reaming process has to deal with increased uncertainty. On the other hand, the finished hole is closely tolerated. To ensure the process reliability the admissible tolerance must be strictly met even in case of uncertainty. This paper presents a possibility to achieve process reliability by a modified process chain with an additional pilot reaming tool. Thereby, the effect of different cutting edge preparation is also analyzed. Further, the influence of the pilot reamer geometry on the final hole quality is investigated.

The bore quality is influenced by machine’s accuracy, work piece and tool errors as well as handling errors. This uncertainty has a huge impact on the quality of the finished bore. During reaming, the majority of tool deflection arises during the unsteady process phase. The entry phase is regarded as the biggest influencing factor for the reamer’s deflection with increasing bore depth. This paper examines the influence of various entry strategies on the bore quality during the reaming process.

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