Early clinical efficacy of total hip arthroplasty through direct anterior approach
GAO Hui
CHEN Zhendong
XU Fangtian
HE Chunlei
Abstract：Objective To compare the difference of short-term clinical effects of primary total hip arthroplasty (THA) through direct anterior approach (DAA) versus standard lateral approach, and to explore the application value of DAA THA. Methods Clinical data of 35 patients were collected who underwent THA in First Affiliated Hospital of Gannan Medical University from August 2013 to August 2014, and were analyzed retrospectively. They were treated by unilateral DAA THA with the assistance of lower extremity traction device and reamer with greater curvature (DAA group), length of incision, operation time, intraoperative estimate blood loss, hospital stay, complications and Harris scores were evaluated. Another 47 patients treated by THA through standard lateral approach (standard group) over the same period were also included, and their parameters were recorded and compared with those in DAA group. Results In DAA group and standard group, the average length of incision, operation time, intraoperative estimate blood loss and hospital stay were (9.5 ± 1.5) cm and (12.3 ± 1.6) cm, (110 ± 14) min and (133 ± 12) min, (219 ± 105) mL and (260 ± 62) mL, (7.8 ± 1.9) days and (9.1 ± 1.8) days respectively, there were statistical differences between two groups (P<0.05). The mean follow-up time was 18 months (range, 14-26 months). The average hip Harris scores were significantly higher at 6 weeks, 3 and 6 months postoperatively in DAA group compared with those in standard group, while the difference had not statistical significance at 1 year postoperatively between two groups. No complications of intraoperative femur fracture, lateral femoral cutaneous nerve injury, postoperative surgical site infection, hip joint dislocation, deep venous thrombosis, implant loosening or heterotopic ossification was observed. Conclusions Compared to THA through standard lateral approach, DAA THA could reduce soft tissue injury, decrease intraoperative estimate blood loss, and be beneficial to rapid recovery of hip function. But DAA THA operation needs longer learning curve, so surgeons should master complicated surgical techniques; Moreover, long-term clinical effects should be investigated further.
Keywords：ArthroplastyreplacementhipDirect anterior approachLateral approachRecovery of function
Publication Date：2016-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 146-151 )