Volume 22 Issue 1
Jan.  2024
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Article Navigation >  Chinese Journal of General Practice  > 2024  >  22(1): 55-58
LUO Chunlin, SU Zhimeng, ZHONG Yuanming, WU Jianghua. Early clinical outcomes of total hip arthroplasty with minimally invasive direct anterior approach and traditional posterolateral approache for femoral head avascular necrosis[J]. Chinese Journal of General Practice, 2024, 22(1): 55-58. doi: 10.16766/j.cnki.issn.1674-4152.003330
Citation: LUO Chunlin, SU Zhimeng, ZHONG Yuanming, WU Jianghua. Early clinical outcomes of total hip arthroplasty with minimally invasive direct anterior approach and traditional posterolateral approache for femoral head avascular necrosis[J]. Chinese Journal of General Practice, 2024, 22(1): 55-58. doi: 10.16766/j.cnki.issn.1674-4152.003330
shu

Early clinical outcomes of total hip arthroplasty with minimally invasive direct anterior approach and traditional posterolateral approache for femoral head avascular necrosis

doi: 10.16766/j.cnki.issn.1674-4152.003330
  • 1.

    Department of Orthopedics, Baoshun Hospital of Qinzhou, Qinzhou, Guangxi 535000, China

Funds:

 82260942

 20213729

  • Received Date: 2023-02-23
    Available Online: 2024-03-09
    Abstract
  •   Objective  To compare the early clinical efficacy of total hip arthroplasty with minimally invasive direct anterior approach and traditional lateral approach for the treatment of avascular necrosis of the femoral head.  Methods  A retrospective study was conducted at Baoshun Hospital of Qinzhou from January 2020 to December 2021, involving 60 patients with avascular necrosis of the femoral head. Among them, 30 patients underwent total hip arthroplasty using the minimally invasive direct anterior approach, while the remaining 30 patients underwent the traditional lateral approach. The data of the two groups were collected to compare various factors, including operation time, bleeding volume, hospitalization time, Harris score of the hip joint, patient satisfaction, and postoperative complications.  Results  The average follow-up period for the 60 patients was 12 months. Statistically significant differences were observed between the two groups in terms of mean intraoperative blood loss [(200.8±5.6)mL vs. (401.2±10.4)mL], length of hospital stay [(6.5±1.1)d vs. (10.6±1.2) d], and Harris score [(90.0±3.3) points vs. (84.4±2.8) points] at 1 month post-operation (P < 0.05). At the 6 month follow-up, the overall satisfaction level in group A was higher than that in group B [(98.5±1.3)% vs. (95.2±1.9)%, P < 0.01] and the scar scale score in group A was lower than that in group B [(1.5±0.8) points vs. (3.2±1.0) points, P < 0.01].  Conclusion  Both the minimally invasive direct anterior approach and the posterolateral approach have demonstrated efficacy in treating avascular necrosis of femoral head. However, the minimally invasive direct anterior approach offers distinct advantages, including significantly reduced postoperative pain, decreased intraoperative bleeding, shorter hospital stays, and higher patients satisfaction levels.

     

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    • References(24)
  • [1]
    TANI T, ANDO W, FUKUSHIMA W, et al. Geographic distribution of the incidence of osteonecrosis of the femoral head in Japan and its relation to smoking prevalence[J]. Mod Rheumatol, 2022, 32(1): 186-192. doi: 10.1080/14397595.2021.1899452
    [2]
    SCHMITZ M R, MURTHA A S, CLOHISY J C. Developmental dysplasia of thehip in adolescents and young adults[J]. J Am Acad Orthop Surg, 2020, 28(3): 91-101. doi: 10.5435/JAAOS-D-18-00533
    [3]
    YOO J I, CHA Y H, KIM K J, et al. Gait analysis after total hip arthroplasty using di rect anteri or approach versus anterolateral approach: a systematic review and meta-analysis[J]. BMC Musculoskelet Disord, 2019, 20(1): 63. DOI: 10.1186/s12891-019-2450-2.
    [4]
    MALDONADO D R, LASETER J R, KYIN C, et al. Direct anterior approach in total hip arthroplasty leads to superior outcomes at 3-month follow-up when compared with the posterior approach: a matched study using propensity score analysis[J]. J Am Acad Orthop Surg Glob Res Rev, 2019, 3(12): e19. DOI: 10.5435/JAAOSGlobal-D-19-00118.
    [5]
    BATAILLER C, ROZINTHE A, MERCIER M, et al. Return to sport after bilateral single stage total hip arthroplasty using the direct anterior approach: a case control study[J]. J Arthroplasty, 2019, 34(12): 2972-2977. doi: 10.1016/j.arth.2019.06.054
    [6]
    PATEL N N, SHAH J A, ERENS G A. Current trends in clinical practice for the direct anterior approach total hip arthroplasty[J]. J Arthroplasty, 2019, 34(9): 1987-1993. doi: 10.1016/j.arth.2019.04.025
    [7]
    MANRIQUE J, PASKEY T, TARABICHI M, et al. Total hip arthroplasty through the direct anterior approach using a bikini incision can be safely performed in obese patients[J]. J Arthroplasty, 2019, 34(8): 1723-1730. doi: 10.1016/j.arth.2019.03.060
    [8]
    PIRRUCCIO K, EVANGELISTA P J, HAW J, et al. Safely Implementing the direct anterior total hip arthroplasty: a methodological approach to minimizing the learning curve[J]. J Am Acad Orthop Surg, 2020, 28(22): 930-936. doi: 10.5435/JAAOS-D-19-00752
    [9]
    HOLZAPFEL B M, RAK D, KREUZER S, et al. Short stem hip arthroplasty via the minimally invasive direct anterior approach[J]. Oper Orthop Traumatol, 2021, 33(4): 288-303. doi: 10.1007/s00064-021-00723-w
    [10]
    LEUNIG M, HUTMACHER J E, RICCIARDI B F, et al. Skin crease "bikini" incision for the direct anterior approach in total hip arthroplasty: a two-to four-year comparative study in 964 patients[J]. Bone Joint J, 2018, 100-B(7): 853-861. doi: 10.1302/0301-620X.100B7.BJJ-2017-1200.R2
    [11]
    KONG X, GRAU L, ONG A, et al. Adopting the direct anterior approach: experience and learning curve in a Chinese patient population[J]. J Orthop Surg Res, 2019, 14(1): 218. DOI: 10.1186/s13018-019-1272-0.
    [12]
    VAN DEN EEDEN Y, VAN DEN EEDEN F. Learning curve of direct anterior total hip arthroplasty: a single surgeon experience[J]. Acta Orthop Belg, 2018, 84(3): 321-330.
    [13]
    STONE A H, SIBIA U S, ATKINSON R, et al. Evaluation of the learning curve when transitioning from posterolateral to direct anterior hip arthroplasty: a consecutive series of 1 000 cases[J]. J Arthroplasty, 2018, 33(8): 2530-2534. doi: 10.1016/j.arth.2018.02.086
    [14]
    NOGLER M M, THALER M R. The direct anterior approach for hip revision: accessing the entire femoral diaphysis without endangering the nerve supply[J]. J Arthroplasty, 2017, 32(2): 510-514. doi: 10.1016/j.arth.2016.07.044
    [15]
    GHIJSELINGS S G M, DRIESEN R, SIMON J P, et al. Distal extension of the anterior approach to the hip usingthe femoral interbundle technique: surgical technique and case series[J]. J Arthroplasty, 2017, 32(7): 2186-2190. doi: 10.1016/j.arth.2017.02.037
    [16]
    SHI X T, LI C F, HAN Y, et al. Total hip arthroplasty for crowe type Ⅳ hip dysplasia: surgial techniques and postoperative complications[J]. Orthop Surg, 2019, 11(6): 966-973. doi: 10.1111/os.12576
    [17]
    FALDINI C, MAZZOTTI A, PERNA F, et al. Modified minimally invasive direct anterior approach through a bikini incision for total hiparthroplasty: technique and results in young femalepatients[J]. J Biol Regul Homeost Agents, 2017, 31(4 suppl 1): 83-89.
    [18]
    PUTANANON C, TUCHINDA H, ARIRACHAKARAN A, et al. Comparison of direct anterior, lateral, posterior and posterior-2 approaches in total hip arthroplasty: network meta-analysis[J]. Eur J Orthop Surg Traumatol, 2018, 28(2): 255-267. doi: 10.1007/s00590-017-2046-1
    [19]
    倘艳锋, 李红军, 刘又文, 等. 不同手术入路行分期双侧人工全髋关节置换术的早期疗效比较[J]. 中国修复重建外科杂志, 2017, 31(11): 1300-1304. https://www.cnki.com.cn/Article/CJFDTOTAL-ZXCW201711005.htm

    TANG Y F, LI H J, LIU Y W, et al. Comparison of short-term effectiveness of staged bilateral total hip arthroplasty via different approaches[J]. Chinese Journal of Reparative and Reconstructive Surgery, 2017, 31(11): 1300-1304. https://www.cnki.com.cn/Article/CJFDTOTAL-ZXCW201711005.htm
    [20]
    SANG W, XUE S, XU Y, et al. Bikini incision increases the incidence of lateral femoral cutaneous nerve injury in direct anterior approach hip arthroplasty: a prospective ultrasonic, electrophysiological, and clinical study[J]. J Arthroplasty, 2021, 36(10): 3463-3470. doi: 10.1016/j.arth.2021.05.012
    [21]
    ZHANG Y, YAO Y, WANG Y, et al. Preoperative ultrasound to map the three-dimensional anatomical distribution of the lateral femoral cutaneous nerve in direct anterior approach for total hip arthroplasty[J]. J Orthop Surg Res, 2021, 16(1): 623. doi: 10.1186/s13018-021-02763-1
    [22]
    PATTON R S, RUNNER R P, LYONS R J, et al. Clinical outcomes of pati ents with lateral femoral cutaneous nerve injury after direct anterior total hip arthroplasty[J]. J Arthroplasty, 2018, 33(9): 2919-2926. doi: 10.1016/j.arth.2018.04.032
    [23]
    HASEGAWA I, WRIGHT A R, ANDREWS S N, et al. Hip offset and l eglength equalization in direct anterior approach total hip arthroplasty without preoperative templating[J]. Hawaii J Health Soc Welf, 2019, 78(11Suppl 2): 26-28.
    [24]
    王水芳, 夏炳江. 以循证理论为基础的中医特色护理对股骨头坏死患者生活质量及治疗效果的影响[J]. 中华全科医学, 2021, 19(2): 328-331. doi: 10.16766/j.cnki.issn.1674-4152.001801

    WANG S F, XIA B J. The influence of TCM characteristic nursing based on evidence-based theory on the quality of life and therapeutic effect of patients with femoral head necrosis[J]. Chinese Journal of General Practice, 2021, 19(2): 328-331. doi: 10.16766/j.cnki.issn.1674-4152.001801
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