Comparison of Early Effect between Primary Total Hip Arthroplasty through Two Approaches

Abstract：Objective To compare the early clinical effects of anterolateral and posterolateral surgical approaches in primary total hip arthroplasty(THA).Methods Between February 2012 and February 2015,76 cases of primary THA were treated by posterolateral surgical approache (PSA).Among them,there were 34 males and 42 females,aged 62 to 78 years with an average of 68.5 years.Another 64 cases of primary THA were treated by anterolateral surgical approache(ASA) at the same period.Among them,there were 33 males and 31 females,aged 50 to 79 years with a mean of 70.5 years.Incision length,operation time,blood loss,postoperative lead flow,time to exercise and postoperative hospitalization time were analysed and compared between two groups.The Harris hip score was used to evaluate and compare hip functions and complications before operation,6 months after operation and the latest follow up between two groups.Results All the patients were followed up and the duration ranged from 10 to 48 months (averaged 25.5 months).1 case in PSA group had delayed infection and received revision 18 months after primary THA.2 cases dislocation were observed in PSA group and underwent manipulative reduction.There was no infection and dislocation case in ASA group.There were no significant differences of the blood loss volume and the postoperative drainage between the two groups(P＞0.05).But the operation time 、the incision length 、the time to exercise and the postoperative hospitalization time of the PSA group were longer than the ASA group (P＜0.05).No significant difference was found in the Harris score between the two groups before operaiton [PSA group(42.43±7.25),ASA group (41.72±6.98),P＞0.05]、6 months after operation [PSA group(87.90±7.36),ASA group (90.20±8.05),P＞0.05]and the last follow up [PSA group(90.30±8.24),ASA group (92.50±9.20),P＞0.05].Conclusion Primary THA through the two approaches(PSA and ASA) can achieve favorable short-term effectiveness.Compared with THA through PSA,THA through ASA need a relatively short operation time and with a relatively small incision.The patients can get out of bed earlier,thus reduce the complications and shorten the hospitalization time.It has advantage about prevention of postoperative dislocation.