Comparative study of direct anterior and posterior approaches in total hip arthroplasty

Abstract

Objective \nTo observe the clinical effects and the recovery of joint function between direct anterior approach (DAA) of total hip replacement and conventional posterior approach (PA) surgery. \n \n \nMethods \nCases of total hip arthroplasty in the orthopaedics department of Chengdu Fifth People’s Hospital from January 2016 to December 2017 were retrospectively analyzed. The operation time, intraoperative blood loss, postoperative drainage volume, haemoglobin concentration, acetabular abduction angle and joint function scores were compared between the two groups by chi-square test or independent t test. \n \n \nResults \nAccording to the inclusion and exclusion criteria, 55 patients treated with DAA (group DAA) and 57 patients treated with PA (group PA) were enrolled in the study. The operation time of DAA group was longer than that of PA group (t=2.64), the amount of bleeding during operation (t=17.47) and of drainage after operation (t=22.06) were less than that of PA group, the abduction angle of acetabulum was less than that of PA group (all P<0.05); the concentration of haemoglobin concentration in DAA group was significantly higher than that of PA group (t=3.44, P<0.05); the Harris and Western Ontario and Mcmaster Universities Osteoarthritis Index (WOMAC) scores in DAA group were significantly higher than those in PA group one month after operation (t=4.44, 5.73; both P<0.05); but the WOMAC score in DAA group was lower than that in PA group at the last follow-up(t=5.96, P<0.05). \n \n \nConclusion \nTotal hip replacement with DAA approach has little blood loss and maintains better joint stability, and it is conducive to postoperative function recovery. \n \n \nKey words: \nArthroplasty, replacement, hip;\xa0Recovery of function