Authors' Response

Abstract

Minimally invasive surgery (MIS) is no longer an experimental procedure. Not only has it been practised since 1993 but the single incision technique was accepted by the National Institute for Health and Clinical Excellence in January 2006 as a safe, proven approach for hip replacement surgery. 1 Furthermore, there is a recognised definition of MIS surgery where the incision is less than or equal to 10 cm. The average age of the cohort described in the paper by Gerrand and colleagues was 71 years. This represents a retired population in whom early rehabilitation and return to work or sport may not be priorities and this could possibly explain why their patients rated length of recovery and stay in hospital as 'not important'. The findings of these authors contrast with the findings in our unit, a high-volume centre performing over 600 hip arthroplasties annually, where the average patient age is 60-65 years, incision length is 8-10 cm, and length of stay is 5 days. MIS hip arthroplasty facilitates earlier recovery and rehabilitation 2 and causes significantly less blood loss with no difference in complication rates. 3