Short Term Outcome After Primary Total Hip Arthroplasty By Minimally Invasive Direct Anterior Approach And Minimally Invasive Incision Posterolateral Approach

BackgroundTotal hip arthroplasty(THA)is used for simulation of the hip prosthesis implantation in the human body to replace diseased due to various reasons of the hip joint,through continuous exploration anatomist and surgeon,surgical incision from previous to minimally invasive incision,the minimally invasive incision posterolateral approach(PLA),the most widely used,can effectively reduce soft tissue injury,wound healing after the more beautiful,but still need to cut off the short external rotators,postoperative posterior dislocation risk.Minimally invasive direct anterior approach(DAA)don’t cut any muscle,without damaging the rear hip structure theory you can completely avoid the posterior dislocation of the hip,in clinical gradually gaining recognition.ObjectiveThis paper reviews research accepted minimally invasive direct front into the road and small incision posterolateral approach road of total hip replacement patients,compared the operation index(operation time,bleeding volume,incision length,prosthesis installation)and postoperative indicators(postoperative complications,rehabilitation.Harris score),the comparison of two surgical approach in total hip arthroplasty in the short-term clinical effect,for clinical selection of surgical approach.MethodThe evaluation index of postoperative evaluation index of total hip arthroplasty in patients undergoing minimally invasive direct anterior approach and small incision after total hip arthroplasty were compared:1.The length of the incision of comparison shows: after road group of minimally invasive surgery and minimally invasive direct front lateral approach road group in the operation time respectively(74.0±8.3 min)and(67.0±5.7)min,the length of incision were(8.0±2.1)cm 、(7.0±3.6)cm,two groups are compared,the difference was not statistically significant(P < 0.05).2.The prosthesis installation comparisons showed that: the installation of operation of hip prosthesis in acetabular abduction angle,rake angle and femoral component rotation angle and pressure with the degree of no difference.Comparison between the amount of bleeding: the total amount of bleeding of minimally invasive direct anterior approach group was(486.4±67.2)ml,dominant blood loss was(353.6 ±44.8)ml,occult blood loss(136.8±19.2)ml;the total amount of bleeding of small incision posterolateral approach group was(575.2±68.8)ml that dominant blood loss was(308±44)ml,occult blood loss(191.2±24.8)ml.in the total amount of bleeding and contact bleeding of minimally invasive direct anterior lateral small incision decreased obviously,the difference was statistically significant(P<0.05).Which is mainly produced by the dominant bleeding bleeding,no the significant difference(P>0.05),the master of direct anterior approach,early treatment of ascending branch of lateral femoral circumflex artery main branches,can shorten the operation time and reduce bleeding,dominant bleeding will also get effective control,so the control volume of hemorrhage minimally invasive direct anterior approach has a significant advantage.4 By comparison of rehabilitation,the patients who received direct anterior approach for total hip replacement can get out of bed early and have no dislocation,and 1 cases of posterior dislocation of hip joint occurred in the lateral group after small incision.5 Postoperative complications showed that no infection,no blood vessels,nerve injury,no limb lengthening or shortening,no prosthesis around fracture,no deep vein thrombosis and other postoperative complications occurred.6 Short-term efficacy after surgery: Harris functional score increased from(46.0± 5.7)points to(93.2±3.5)points,the two groups in the postoperative 3,6,12 months of hip Harris functional score comparison,the difference was not statistically significant(P>0.05).ConclusionMinimally invasive direct anterior approach can be used as the first choice for primary total hip arthroplasty.