A Comparative Study On The Early Efficacy Of Two Approaches In Total Hip Arthroplasty Based On The Concept Of Enhanced Recovery After Surgery

Objective: The clinical value of modified anterolateral invasive approach(ALMI)THA was discussed by comparing the difference of early clinical efficacy between the ALMI and the traditional anterolateral approach based on the concept of Enhanced Recovery After Surgery(ERAS).Methods: All patients underwent perioperative period under the concept of ERAS.This study included 80 patients who underwent the first total hip replacement at the affiliated hospital of zunyi medical university from November 2017 to May2019.According to the different surgical approaches,the subjects were divided into two groups: 40 hips received the ALMI THA and 40 hips received the traditional anterolateral approach THA.The general preoperative data of the two groups of patients were collected and counted.And analysis of two groups of incision length,intraoperative blood loss,operating time,differences in hemoglobin value,creatine kinase(CK-NAC),down time,length of hospital stay,Imaging indicators,postoperative 3rd,7th and 14 th day the depth of the liquid dark area under color doppler ultrasound was foundthe,vas pain score and the difference between preoperative and postoperative circumference of the thigh in the surgical area,harris functional score and single-leg independent experiment in 1 month,3 months and 6months after surgery,the postoperative complications(for postoperative patients with neurological symptoms and signs line double lower limbs electromyography and evoked potential,in the evaluation of patients with lower limb electrophysiological changes,Patients with postoperative lower extremity swelling were examined by colordoppler ultrasound to assess the extent and extent of thrombosis).Results:1.There were no statistically significant differences in age,gender,BMI,preoperative indicators(VAS pain score,Harris functional score,single-leg independent experiment)between the two groups(P>0.5).2.Two groups of creatine kinase,down time,postoperative hospitalization time differences statistically significant(P<0.05).3.postoperative day 3,7 days the depth of the liquid dark area in the surgical area and postoperative day 3,7 days,14 days Indicators(postoperative circumference of the thigh in the surgical area,VAS pain score)and postoperative January Harris score differences statistically significant(P<0.05),modified anterolateral minimally invasive approach group is superior to the anterolateral approach to the traditional group.In addition,at different time points after surgery,the analysis of variance of longitudinal multiple comparisons between the two groups found that both groups improved more than before,but the improvement rate was faster in the minimally invasive group.4.There was no significant difference in incision length,intraoperative blood loss,Preoperative and postoperative hemoglobin differences,postoperative imaging evaluation,positive rate of single leg independent experiment,Preoperative and postoperative 3 months and 6 months Harris score and postoperative complications between the two groups(P>0.05).Conclusion:The modified anterolateral minimally invasive approach in THA under the guidance of ERAS has the advantages of less trauma,less pain,shorter time to go to ground and stay in hospital,and faster early functional recovery compared with the traditional anterolateral approach,which is more in line with the concept of ERAS.