A Comparition Of The Early Effect Of SuperPATH Approach And Standard Posterolateral Approach For Total Hip Arthroplasty

Objective:To investigate the clinical application and value of Super PATH approach in reducing surgical trauma and rapid rehabilitation compared with the standard posterolateral approach.Methods:From September 2016 to June 2018,20 primary hip replacement patients who met the indications for total hip replacement were randomly divided into the Super PATH approach group(denoted as experimental group or S group)or the standard posterolateral approach group(denoted as control group or M group).Among them,there were 7 males and 13 females,aged from 61 to 80 years old,with an average age of 70±6.79 years old.The surgeries were performed by the same group of doctors.Hip function was assessed at the time of 1 day,3 days,2 weeks,6 weeks,3 months,and 6 months postoperatively,totally 6 times.The main evaluation items included operation time,incision length,intraoperative blood loss,postoperative Harris hip function score,Barthel index,Berg balance scale,VAS score,and the anteroposterior X-ray of the pelvis.Statistical analysis was performed and the results were evaluated.Results:All 20 patients were basically followed up.Three days after surgery,the average score of Berg balance scale in the Superpath group was 17.8±0.57,significantly higher than the average score of 12.2±1.64 in the standard posterolateral approach group(P<0.01).Six weeks after surgery,the average score of Berg balance scale in the Superpath group was 45.8±0.74,significantly higher than the average score of 41.8±4.26 in the standard posterolateral approach group(P<0.05).Three months after surgery,the Harris hip function score of the Superpath group averaged 96.2±3.76,significantly higher than that of the standard posterolateral approach group(87.9±1.26,P<0.01).During the 6-month follow-up period,there were no postoperative lower limb deep vein thrombosis,pulmonary embolism,joint dislocation,wound infection,prosthesis loosening/subsidence and other adverse events.Six months after surgery,the hip joints of the two groups were stable and well mobile.Conclusions 1.Patients undergoing total hip arthroplasty using the Super PATH approach recovered faster and better within 3 months after surgery than those using the standard posterolateral approach.2.Patients undergoing total hip arthroplasty using the Super PATH approach had no significant advantage over patients undergoing the standard posterolateral approach 6 months after surgery.3.Compared with the standard posterolateral approach,patients undergoing total hip arthroplasty using the Super PATH approach did not experience an increased incidence of complications.4.The surgeon’s familiarity with this approach and related surgical instruments is a prerequisite for the success of the operation,otherwise,the operation time and intraoperative blood loss will increase.5.The surgeon should fully evaluate the patient’s condition and surgical requirements before the operation,and select the appropriate patient for this approach to achieve good early efficacy.