Clinical Efficacy Study Of The DAA Stent-assisted Direct Anterior Approach For Minimally Invasive Total Hip Arthroplasty To DDH In The Guide Of The Theory Of Muscle And Bone Are Both Important

Objective To explore the clinical effects of the two types of THA applied to DDH by comparing DAA stent-assisted direct approach in the Guide of the theory of Muscle and Bone are Both Important and posterior lateral approach.Methods Retrospective analysis of 60 patient dates who underwent total hip arthroplasty in our hospital for the diagnosis of DDH from January 2012 to January 2017,including 28 males and 32 females,aged 43-78 years(Median=62 years).In order to rule out the differences in experience and proficiency of different surgeons,all patients were operated by the same orthopedist.According to the different surgical approaches,there were 2 groups,including 30 cases in the DAA group.In the Guide of the theory of Muscle and Bone are Both Important,minimally invasive DAA total hip arthroplasty was used.In the posterior approach group,30 cases were treated with posterior approach total hip arthroplasty.The Incision length,the operation time,intraoperative blood loss,postoperative flow,the intraoperative and postoperative prosthesis angle,the first walk after the operation,the postoperative hospital stay,hip Harris score at various stages after surgery and the complication were compared between the two groups.Results All patients in the 2 groups were followed up for 25 to 28 months(Median=26.1±2.9 months),there are no complication were found in two groups.There are no significant differences in age,gender,BMI,Crowe classification,etc.between the 2 groups(P>0.05).The Incision length,intraoperative blood loss,postoperative flow,the first walk after the operation,postoperative hospital stays were shorter in DAA approach groups compared to posterior lateral approach groups(P<0.001),There was no statistical difference in operation time between the 2 groups(P=0.339).There were no significant differences for anteversion and inclination in DAA approach group between intra-operative and postoperative(P=0.552;P=0.074).There were significant differences for posterior lateral approach group between intra-operative and postoperative(P=0.010;P=0.005).There were no significant differences in Harris hip function scores before operation between the 2 groups(P=0.074).The Harris hip function scores were higher in DAA group compared to PLA group at 1 week,1 month and 3 month after the surgery(P<0.001).There was no statistical difference in Harris hip function scores between the 2 groups before the surgery and at 6 month,1 year and 2 year after the surgery(P>0.05).Conclusion In the guide of muscle and bone are both important,the DAA stent-assisted Direct Anterior Approach is used to treat Crowe type I and Crowe type II DDH through the real muscle gap entry,avoiding the damage to the " muscle " around the joints,has the advantage of reducing soft tissue damage,accurate placement of the acetabular prosthesis and accelerating postoperative rehabilitation compared with the posterolateral approach.However,there is no obvious difference between the two therapies in operative time and long-term hip function recovery.