Early Clinical Efficacy And Application Value Of The SuperPath Minimally Invasive Total Hip Arthroplasty

BackgroundIn the present clinical,the disease associated with the hip joint is very common.In the early stage of the disease,through the timely treatment can cure or delay the progression of hip joint disease,but there are also quite a number of patients did not receive effective treatment or with the continuous progress of the disease eventually led to the loss of the hip joint function in patients suffering from hip joint,and this is accompanied by severe pain and discomfort symptoms continued to affect the daily life and the quality of life of patients.Total hip arthroplasty is an effective treatment for end-stage hip disease including femoral neck fracture,has now become a standard and mature treatment technology for hip diseases,so many patients were relieved of long-term pain,and reconstruct the function of hip joint.A number of patients have chosen to perform total hip arthroplasty after long-term suffering of hip related diseases.It relieved the long-term pain of patients,corrected the deformity of the hip joint and restored the good joint function,and effectively improved the quality of life of the patients.It has been recognized by many department of orthopedics doctors and patients,and has been widely promoted and applied.The traditional total hip arthroplasty soft tissue injury,intraoperative bleeding,postoperative complications is higher,with the improvement of surgical techniques and instruments,minimally invasive total hip arthroplasty has been greatly developed,one of the typical one of Super PATH after the minimally invasive approach came into being.The Super PATH minimally invasive approach is a concept of soft tissue protection,which can be separated only in the intertissue gap.This minimally invasive approach using the piriformis muscle and the gluteus minimus clearance operation.Because the short circumspin group of the hip is not needed to be cut off,the joint capsule and muscle around the hip joint are almost completely preserved.Combined with the application of the rapid rehabilitation pathway,the operative approach achieved little damage to the soft tissue,less blood loss during operation,early postoperative functional rehabilitation exercise,low incidence of complications and shortened hospital stay,which greatly improved patient satisfaction.ObjectiveTo compare the difference of short-term clinical effects of primary total hip arthroplasty(THA)through SuperPath minimally invasive THA versus standard lateral approach,and to explore the clinical application value of SuperPath THA.MethodsClinical data of 31 patients were collected who underwent SuperPath THA in our hospital from March 2015 to September 2016,and were analyzed retrospectively.The length of incision,operation time,intraoperative estimate blood loss,hospital stay,complications,modified Barthel index,Berg balance scale score,Harris hip score and prosthetic prosthetic position were evaluated.Another 21 patients treated by THA through standard lateral approach(standard group)over the same period were also included,and their parameters were recorded and compared with those in Superath group.ResultsThe operation time of the two kinds of surgical approaches was compared.The SuperPath group was(108.4±25.3)min,and the standard group was(88.1±1304)min,with statistical difference:The amount of bleeding in the two surgical approaches was(230.3±147.6)ml in the SuperPath group and(294.7±139.2)ml in the standard group,with no statistical difference.The incision length of the two surgical approaches was(6.6±0.4)cm in the SuperPath group,and the standard group was(9.3±0.4)cm,with statistical difference.The time of hospitalization of the two surgical approaches was(5.1±0.8)days in the SuperPath group,and the standard.group was(8.3±2.2)days,with statistical difference.The early functional recovery of two surgical approaches was significantly higher in the SuperPath group than in the standard group on the first day,the third day and the five day after operation.The Berg balance scale score and the modified Barthel index were statistically significant.The Harris scores of hip joint function in two patients after operation were compared with those in standard group.SuperPath group was better than standard group in 6 weeks and three months after operation.Compared with two surgical approaches,the abduction angles of group SuperPath and standard group were(42.3±5.1)degrees and(42.7±3.4)degrees,respectively,and the anterior tilt angles were(11.3±3.4)degrees and(12.2±3.6)degrees,respectively.Conclusions1,SuperPath minimally invasive approach and the traditional posterolateral approach can achieve good clinical efficacy when total hip arthroplasty needs to be performed for hip related diseases.2,SuperPath minimally invasive posterior approach total hip arthroplasty in patients with early postoperative recovery is better than the traditional posterolateral approach,but there is no significant difference in long-term hip function.3,SuperPath minimally invasive posterior total hip replacement and traditional posterolateral approach total hip replacement patients have no significant difference in postoperative complications.4,SuperPath minimally invasive posterior approach total hip replacement surgery requirements are relatively high,and need a certain learning curve and clinical accumulation.5,By reasonably grasping the operative indications,we should make full use of the concept of rapid rehabilitation,and the early rehabilitation rate of SuperPath minimally invasive posterior approach for total hip arthroplasty is encouraging.This approach is worthy of clinical application.