The Clinical Application And Experience Summary Of Direct Anterior Approach In Total Hip Arthroplasty

Objective To explore the clinical application and relevant experience summary of direct anterior approach(DAA)in total hip arthroplasty(THA).Method From October 2014 to January 2016,156 patients(156 hips)received THA therapy in our hospital.Based on the surgical approach they were divided into 2 groups.There were 82 cases in group A,which including 50 males and 32 females,aged from 43 to 74 years,accepted posterolateral approach(PLA)total hip arthroplasty.There were 74 cases in group B,which including 42 males and 32 females,aged from 44 to 76 years,accepted direct anterior approach in total hip arthroplasty.The incision length,operation time,intraoperative blood loss,postoperative drainage tube retention time,wound drainage volume,weight-bearing time,hospitalization time and perioperative complications were recorded.At different time points,the visual analogue scale(VAS)and Harris hip function scores were observed and analyzed.Results Both of the 2 groups were been successfully operated,there was no significant difference in the operation time(P>0.05).In the incision length,intraoperative blood loss,postoperative drainage time and wound drainage,group B was significantly smaller than the A group(P<0.05).The partial load-bearing time,complete weight-bearing time and total length of hospital stay in group B were significantly shorter than those in group A(P<0.05).After the surgery,the VAS score of the 2 groups was gradually decreased(P<0.05),and at different time points,the score of group B was lower than that of group A(P<0.05).The scores of Harris hip function in the 2 groups were gradually increased(P<0.05),and at different time points,the score of group B was higher than that of group A(P<0.05).Six months after the operation,the excellent and good rate in group B was94.6%(70/74),and 84.1%(69/82)in group A,there was significant difference between the 2 groups(P<0.05).The follow-up time ranged from 12 to 21 months(mean,16.3±4.1months).The complication rate was 9.5%(7/74)in group B and 7.3%(6/82)in group A,there was no significant difference between the 2 groups(P>0.05).Conclusion Direct anterior approach and posterolateral approach of total hip arthroplasty are common surgical procedures for the treatment of hip disorders,but direct anterior approach has a characteristic of with smaller trauma,less blood loss,faster pain relief,shorter recovery time.It could improve the hip function better,and suitable for senior physicians with rich clinical experience to carry out.