Comparative Study Of The Clinical Efficacy Between Direct Anterior Approach And Posterior Lateral Approach In Total Hip Arthroplasty

Objective:The purpose of this retrospective study was to compare the short-term clinical effect and radiographic outcome of between direct anterior approach(DAA)and the posterior lateral approach(PLA)in total hip arthroplasty(THA).Methods:A total of 57 cases of primary THA were treated from February 2016 to February 2017,among which 27 cases used DAA,and 30 cases used PL A.The preoperational Harris hip score,incision length,operation time,intraoperative blood loss,postoperative 48 hour drainage volume,hospital stay,VAS of 1,7 day,3 months after operation,HHS of 1 weeks,1,3,6 months after operation,acetabular anteversion,acetabular abduction of the two groups were observed and recorded.And the complication were recorded,such as the femoral fracture,great trochanter fracture,postoperative dislocation and lateral femoral cutaneous nerve injury.Statistic analysed the two groups of data,so as to reach a conclusion.Results:The age,sex～body mass index and disease had no significant differences in DAA and PLA THA.(p>0.05).The incision length of PLA group(7.70±1.09)cm was shorter than DAA group(8.56±1.74)cm.Operation time of DAA THA(91.30±45.14)min was longer than PLA THA(73.13 ± 18.72)min,(p<0.05).The hospitalization time of DAA group(6.04 ± 1.02)days and PLA group(8.53±5.55)days had statistically significant difference.Intraoperative blood loss and postoperative 48 hour drainage volume was no statistically significant difference between the two group(p>0.05).The VAS pain sore of the DAA group was lower than that of the PLA groupl,7 day after operation(p<0.05).But 3 month after operation VAS pain sore were not statistically significant difference(p>0.05).The comparisons of the HHS between the DAA and PLA group were as the follows:The HHS of 1 week after operation was(65.59±2.06)in DAA group and(51.18±5.05)in PLA group,the HHS of 1 month after operation was(80.79±4.39)in DAA group and(68.75±7.11)in PLA group,the HHS of 3 month after operation was(89.68±2.09)in DAA group and(83.27±6.13)in PLA group,DAA THA group was better than PLA THA group(p<0.05).Acetabular anterversion angle(16.40°±4.86°)and(15.75°±6.24°),abducation angle of acetabum(42.90°±5.54°)and(43.74°±6.33°).There ware no significantly difference in acetabular anterversion angle,abducation angle of acetabum and postoperation 6 month HHS(93.47±1.60)and(92.10±3.48)between the two groups(p>0.05).One hundred percent of the cup inclination angle in the DAA group and 93.33%in the PLA group had been implanted within Lewinnek the safe zone.The perioperative complications were not statistically different between the two group(p>0.05).Conclusion:Comparative study of the clinical efficacy between DAA and PLA,postoperative hospitalization in DAA was shorter,low postoperative pain,early postoperative hip joint function recovery in DAA was fast,it could bring faster rehabilitation,got better hip stability.