Evaluation Of Rapid Rehabilitation Effect Of Direct Anterior Approach In Total Hip Arthroplasty

Objective:the purpose of this study was to investigate the efficacy of direct anterior approach in the rapid rehabilitation of hip arthroplasty,and to compare the efficacy of the commonly used posterior lateral approach in the short-term rehabilitation of hip arthroplasty.Methods:DAA and PLA approaches were performed in the third affiliated Hospital of Nanchang University from March 2017 to September 2018.The patients were divided into two groups: DAA group and PLA group.General anesthesia was used for surgical anesthesia,and the operation was performed by the same operator.The clinical data of incision length,operation time and intraoperative blood loss were counted.Fasting venous serum C-reactive protein(C-reactin protein CRP),)was recorded 1 day before operation and 2 hours and 1,3 days after operation.Creatine kinase(creatine kinase CK)value.Hip joint function was evaluated by hip joint Harris(HHS)score.The data results were statistically analyzed by SPSS22.0software,and there was statistical significance in setting p < 0.05.Results:Compared with PLA group,DAA group had less intraoperative blood loss and shorter incision length,but the operation time was longer,and the difference was statistically significant(P<0.05).The levels of CRP and CK in the serum of the two groups were higher than that on the first day before the surgery,reaching a peak on the first day after the surgery,and began to decline one day after the surgery,with statistically significant differences(P<0.05).The trend of serum CRP and CK levels before and after surgery in DAA group and PLA group was roughly the same,but the CRP and CK levels in the same period after surgery in DAA group were significantly lower than those in PLA group.There was no significant difference in preoperative HHS score between the two groups(P>0.05).At 2 and 4 weeks after surgery,the HHS score of DAA group was significantly higher than that of PLA group(P<0.05),and there was no statistical significance in the HHS score of the two groups at 3 months after surgery(P > 0.05).Conclusion:DAA Total hip replacement has a low degree of injury to muscles and other soft tissues,a short incision length and a small amount of intraoperative blood loss.The choice of DAA for total hip replacement is conducive to the early and rapid postoperative recovery of patients,but there is no significant difference in the long-term impact of the two surgical approaches on hip function.Although DAA approach takes a little longer and has a longer learning curve,it has a significant effect on accelerating postoperative rehabilitation and is worthy of clinical application.