Journal of Peking University(Health Sciences) >
Early functional recovery of direct anterior approach versus anterolateral approach for total hip arthroplasty
Received date: 2017-03-28
Online published: 2019-04-26
Supported by
the Science Foundation of Guizhou Province[No. (2015) 3044];the Subsidy Fundation of National Natural Science Fundation of Guizhou Provincial People’s Hospital (Guizhou Science and Technology Platform [2017]5724])
Objective: To evaluate the early clinical effects of direct anterior approach (DAA) versus anterolateral approach (ALA) on safety and functional recovery following total hip arthroplasty (THA).Methods: Between January 2015 and May 2016, a randomized clinical trial was performed at Guizhou Provincial People’s Hospital. A total of 50 patients who underwent THA were allocated for either the DAA (n=25) or ALA (n=25). DDA group had 25 patients (25 hips), including 16 males and 9 females, with the mean age of (62±2) years, BMI of (23.26 ±4.95) kg/m 2(range: 19.6 to 29.5), and preoperative Harris score of (33.4 ±15.5) (range: 17.9 to 48.9). Eleven cases were diagnosed as primarily hip osteoarthritis, 4 were developmental dysplasia of the hip (DDH, Crowe 2) and 10 were hip avascular necrosis (AVN, Stages 3 to 4). ALA group had 25 patients (25 hips), including 18 males and 7 females, with the mean age of (59±3) years, BMI of (25.35 ±5.8) kg/m 2(range: 18.2 to 29.8), and preoperative Harris score of (38.6 ± 16.7) (range: 23.1 to 56.5). Ten cases were diagnosed as primarily hip osteoarthritis, 3 were developmental dysplasia of the hip (DDH, Crowe 2) and 12 were hip avascular necrosis (AVN, Stages 3 to 4). Operation time, incision length, intra-operative blood loss and functional recovery of hip postoperatively were compared between the two groups.Results: The surgical incision of both groups were stageⅠhealing. The mean follow-up was 6 months. There was no significant difference regarding operation time, incision length, and intra-operative blood loss between the two groups. However, we also found that there was no significant difference in the Harris score 3 months and 6 months postoperatively. In addition, two patients in ALA group suffered claudication (physical examination: abduction dysfunction of hip). We also found that DAA group resulted in better recovery of abductor strength and gait than ALA group during early follow-up.Conclusion: Both DAA and ALA could obtain good results of early curative effect following THA. Moreover, DAA resulted in better gait than ALA during early follow-up.
Sen-lei LI , Xian-teng YANG , Xiao-bin TIAN , Li SUN . Early functional recovery of direct anterior approach versus anterolateral approach for total hip arthroplasty[J]. Journal of Peking University(Health Sciences), 2019 , 51(2) : 268 -272 . DOI: 10.19723/j.issn.1671-167X.2019.02.013
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