Postero-lateral Minimal Incision Large Head Diameter Ceramic-on-ceramic Total Hip Arthroplasty Short Term Outcome Analysis

bjective To explore the clicinal effect of posterolateral approach for minimalincision surgery large head diameter ceramic-on-ceramic total hip arthroplasty.Mehods From August2009to June2012, collect clinical and follow-up datasuch as the patients who received the posterolateral minimal incision large headdiameter ceramic-on-ceramic of total hip arthriplasty in the Division2oforthopedics of Fujian Provincial Hospital. Patients with complete data total46cases of52hips, including29male（s33hips）,17female（s19hips）. Their averageage of44.48years (23to83).Body mass index of all cases are less than30kg/m2.The composition of disease.：4cases (4hips) of hip osteoarthritis，24cases (29hips) of the avascular necrosis (Ⅲ-Ⅳp eriod)，9cases (9hips) of Femoral neckfracture，2cases (2hips) of Ankylosing spondylitis，1case (2hips) of Rheumatoidarthritis，6cases (6hips) of Congenital hip dysplasia. Their average BMI23.78kg/m2(17.7~29.9)，preoperative Harris score41.6(23.6~56.8).The length ofincision，operative time，blood loss and transfusion blood loss of intraoperative,the volume of postoperative drainage，amount of blood transfusion, days ofpostoperative hospitalization, postoperative Harris scoring, prosthesis position,complications were observed.Results All patients had a mean follow-up of17.09months（6～40）. All thePatients were stage I incision healed. The operative time:64.8min (52-78); Thelength of incision:8.5cm (7.1~10.5); The blood loss of intraoperative:295.7ml(160~410); The volume of postoperative drainage:143.6ml (110~240); Thedays of postoperative hospitalization:7.5days (5~11); The Harris scores ofpreoperative:41.6(23.6~56.8), The Harris scores of postoperate3months:90.7(79.493.6).Harris rated as excellent, good, fair, poor patients, respectively 15,28,3,0. The good rate was93.47%, compared with the preoperative significantstatistical significance (P <0.05）; The Harris scores of postoperate6months:93.2(86.9~97.2), Harris rated as excellent, good, fair, poor patients, respectively27,19,0,0. The good rate was100%, and the postoperative Harris scores havesignificant statistical significance (P <0.05）; The last follow-up Harris score:95.6(91.3~98.5), Harris rated as excellent, good, fair, poor patients, respectively33,13,0,0.The good rate was100%.All of the patients of postoperative hip jointpain disappeared basically, function improved significantly.There have nocomplications such as dislocation, infection, leg length discrepancy, deep venousthrombosis and others complications occurred. All cases X-ray shows that theposition of prosthesis is good, and have no complications appeared in theprocess of follow-up,such as dislocation, prosthesis loosening and shiftphenomenon.Conclusion Posterolateral approach for minimally invasive surgery large headdiameter ceramic-on-ceramic total hip arthroplasty have those advantages,such asless bleeding, more smaller incision, light pain, postoperative recovery fast,lagerin the range of motion, less complications.The clinical follow-up showed that therecent clinical effect is good.