Clinical Comparative Study On Treatment Of Osteonecrosis Of The Femoral Head Between Anterolateral And Posterolateral Approaches In Total Hip Arthroplasty

Objective:The purpose of this study is to compare the clinical effects and differencesbetween anterolateral and posterolateral approaches in Patients with Osteonecrosis ofThe Femoral Head,To provide certain clinical statistical evidence for the selection ofsurgical procedure.Methods: Totally78patients performed with total hip arthroplastybecause of Osteonecrosis of The Femoral Head from January2011to January2013atFujian Medical University Union Hospital were retrospectively analyses.All of themreceived more than1year’ follow-up.The anterolateral group included of20menand16women,range from28to85years old,average age was59.3±12.1,BMI rangefrom18to33,average BMI was24.0±3.5,Harris hip scoring preoperative was40.1±3.7;The posterolateral group included of20men and22women,range from30to89years old,average age was58.6±12.8,BMI range from17to35,average BMIwas24.5±4.4,Harris hip scoring preoperative was39.1±3.1.By comparing andstatistical analysis to two different surgical approaches in the length of incision,operative time,blood loss,acetabular anteversion,postoperative drainage,postoperativehospitalization,Harris hip scoring postoperative and complication.Results: Allpatients tolerated the operation well.The anterolateral group:the average length ofincision was11.8±3.4cm,the mean operative time was105.8±24.5min,The meanoperative bleeding was425.0±193.3ml,the average acetabular anteversion was15.0±5.3°,the average postoperative drainage was240.3±82.7ml,the averagepostoperative hospitalization was7.1±2.1d,the average Harris hip scoringpostoperative was90.5±6.8,good in34hips, good rate were94.4%,1case of skinwound infection;The posterolateral group:the average length of incision was12.0±3.3cm,the mean operative time was80.7±27.1min,The mean operative bleedingwas367.9±156.1ml,the average acetabular anteversion was22.3±3.6°,the averagepostoperative drainage was215.0±109.2ml,the average postoperative hospitalizationwas6.7±1.7d,the average Harris hip scoring postoperative was88.6±6.7,good in40hips, good rate were95.2%,1case of skin wound infection,and1case of postoperativedislocation.There was significant difference of operative time and acetabularanteversion between the two groups(P<0.05);There was not significant difference ofthe length of incision,blood loss,postoperative drainage,postoperative hospitalization,Harris hip scoring postoperative and complication between the two groups(P>0.05).Conclusion: There was not significant difference of clinical effect on treatment ofOsteonecrosis of The Femoral Head between anterolateral and posterolateralapproaches in Total Hip Arthroplasty.Anterolatera approach is the best choice for the prevention of postoperative dislocation;Posterolateral approach has some advantagesin surgical exposure,surgery can be completed within a relatively small operationtime.