Clinical Comparative Study On The Treatment Of ONFH Between Direct Anterior Approach And Posteroralateral Approach In Total Hip Arthroplasty

Objective:To review short-term clinical efficacy of the minimally invasive direct anterior approach (DAA) and posterolateral small incision approach (PLA) in the treatment of osteonecrosis of the femoral head with total hip arthroplasty, in order to provide evidence for option of these diseases surgery approach and clinical outcome evaluation.Method:It is a retrospective study of 52 ONFH cases treated with total hip arthroplasty from 2014.10 to 2015.11 in the Sichuan Provincial Peoples Hospital.Including 27 cases of minimally invasive direct anterior approach (DAA) and 25 cases of posterolateral small incision approach.To observe and analysis the effects of DAA and PLA on the operating post-operating and cured conditions. Recording the surgical time, blood loss, postoperative complications, the Harris score of patients before and after operation for 1、3、6 months. To prepare of the consolidated database, to analyze the two variables, compare the efficacy of two approach.Result:All the patients were successfully replaced, and were followed up for 1-6 months. Compared of PLA group the DAA group less blood loss, less postoperative hospitalization, the difference was statistically significant, P<0.05. The length of Incision, the drainage after operation, 1、3、6 months after surgery, the hip score、VAS score were recorded, there was no significant difference between the DAA group and PLA group No dislocation was observed in the DAA group; one case of dislocation were observed in the posterolateral group.Conclusions:Direct anterior approach total hip arthroplasty can reduce bleeding volume, preserve hip muscles and achieve faster recovery, but PLA group can shorten the operation time. In the followed-up period, the DAA group and PLA group clinic effects was no significant difference.