Comparative Study Between Direct Anterior Approach And Posterolateral Approach For Total Hip Arthroplasty In Early Postoperative X-rays

Object To compare and analyze Direct anterior Approach(DAA)and Posterolateral Approach(PLA)for total hip arthroplasty in early postoperative hip X-rays for total hip arthroplasty(THA)to discuss the advantages and disadvantages of these two approaches to provide reference for clinicians on how to choose surgical approach.Methods From January2015 to October 2015,the clinical data of patients who underwent total hip arthroplasty by Direct anterior Approach or Posterlateral Approach was collected from orthopedics Department 2 of Orthopedics of Fujian Provincial Hospital,64 hips of 61 patients in total.The DAA group: 35 patients(37 hips),22 male patients(24 hips),13 female patients(13 hips),average age 56.5 yeas old(34-76).21 patients(23 hips)of avascular necrosis(III-IV period),12 patients(12 hips)of hip osteoarthritis,2 patients(2 hips)of femoral neck fracture.The PLA group: 26 patients(27 hips),16 male patients(17 hips),10 female patients(10 hips),average age 55.8 yeas old(42-78).14 patients(15 hips)of avascular necrosis(III-IV period),11 patients(11 hips)of hip osteoarthritis,1 patients(1 hips)of femoral neck fracture.All patients underwent standard bilateral hip radiographs in 1 week and follow up time(6~12 months)after surgery,evaluate the acetabular abduction,the acetabular anteversion,acetabular periprosthetic radiolucency,the acetabular position,the angle between the femoral stem prosthesis axis and the medullary cavity axis,the ratio between the femoral stem prosthesis axis and the medullary cavity axis and the actual leg lengthdiscrepancy in 2 groups.Results The X-rays in 1 week after surgery: the acetabular abduction: DAA group:(39.95±4.07)°,the PLA group:(39.84±3.77)°,there is little significantly difference in these two groups(P > 0.05).The acetabular anteversion: DAA group:(14.57±3.83)°,the PLA group:(14.17±3.63)°,there is little significantly difference in these two groups(P>0.05).The angle between the femoral prosthesis axis and the femoral axis: the DAA group:(1.46±0.71)°,the PLA group:(1.50±0.70)°,there is little significantly difference in these two groups(P>0.05).The actual leg length discrepancy: the DAA group:(4.26±2.15)mm,the PLA group:(4.20±2.34)mm,there is little significantly difference in these two groups,too(P>0.05).There is no acetabular periprosthetic radiolucency in two groups.The acetabular position were all well.The ratio between the femoral stem prosthesis axis and the medullary cavity axis in these two groups were all satisfied.The X-rays in last follow-up time after surgery: the acetabular abduction: DAA group:(39.95±4.05)°,the PLA group:(39.85±3.75)°,there is little significantly difference in these two groups(P>0.05).The acetabular anteversion: DAA group:(14.57±3.82)°,the PLA group:(14.16±3.60)°,there is little significantly difference in these two groups(P>0.05).The angle between the femoral prosthesis axis and the femoral axis: the DAA group:(1.45±0.69)°,the PLA group:(1.50±0.67)°,there is little significantly difference in these two groups(P>0.05).The actual leg length discrepancy: the DAA group:(4.24±2.12)mm,the PLA group:(4.18±2.34)mm,there is little significantly difference in these two groups,too(P>0.05).There is no acetabular periprosthetic radiolucency in two groups.The acetabular position were all well.The ratio between the femoral stem prosthesis axis and the medullary cavity axis in these two groups were all satisfied.Conclusion There is little apparently differrence in Direct anterior Approach and Posterolateral Approach for total hip arthroplasty in early postoperative hip X-rays for total hip arthroplasty.The result of the study is reliable,it can provide reference for clinicians on how to choose surgical approach.