Comparing The Bone Stock Of Anterior-posterior Wall Of Acetabulum In Total Hip Arthroplasty Through DAA And PA

ObjectiveThe purpose of this study was to reveal differences in the bone stock of the anterior and posterior walls between the direct anterior approach(DAA)and the posterior approach(PA)by using CT images-MethodsA retrospective review was performed on consecutive series primary THAs completed at our joint center from October 2015 to December 2017 by one experienced fellowship trained surgeon.The volume of intraoperative bleeding,length of operation,preoperative Harris score,pain(VAS)score,3-day VAS score and 4-week Harris score post-operation and the number of days of hospitalization after operation were collected from medical record system.Patients data on peri-operation hip joint CT images were collected and analyzed with parameters of the cross-sectional area(CSA),height of the anterior and posterior column,acetabular diameter,and anteversion.Sixty hips that underwent the DAA and PA with complete data were analyzed by SPSS 18.0.ResultsFor intra group comparison,post-operation data of CSA of anterior and posterior,height of anterior and posterior of acetabulum was less than pre-operation both the two group(p<0.01),diameter of acetabulum was larger than pre-operation(p<0.01),while the anteversion was no significant differences in peri-operation both the groups(p>0.05).For inter group comparison,there was no significant difference in preoperative parameters between the two groups(p>0.05):The intraoperative bleeding volume of DAA was less than that in PA group(p<0.01);the operation time was shorter than that in PA group(p<0.01);the general evaluation parameters such as 3-day VAS score and 4-week Harris score post-operation and the number of days of hospitalization after operation in DAA group were better than those in PA group(p<0.01):The CSA of the anterior column of the acetabulum post-operation in the DAA group was larger than that in the PA group with statistically significant(2.62 ± 0.77cm2 vs 2.22 ± 0.73cm2,p=0.04);No statistically significant differences were observed for the CSA of the posterior column(p=0.41);the height of the anterior(p=0.74)and posterior column(p=0.33);acetabular diameter(p=0.67)and anteversion(p=0.80)post-operation.ConclusionsDAA for THA not the risk factor of leading to eccentric reaming the anterior wall of acetabulum.Combining current research reports,there are more reasons indicating that the DAA is a promising approach for THA.We look forward to further studies of multicenter,prospective randomized controlled trials to confirm it.