[Short-term effectiveness of minimally invasive total hip arthroplasty by direct anterior approach].

OBJECTIVE

To evaluate the short-term effectiveness of minimally invasive total hip arthroplasty (THA) by direct anterior approach (DAA).

METHODS

Between January and August 2014, THA was performed on 48 patients (60 hips) by DAA (group A), and on 72 patients (92 hips) by posterolateral approach (group B). There was no significant difference in gender, age, etiology, course, and preoperative visual analogue scale (VAS), Harris hip score (HHS), and hip range of motion (ROM) between 2 groups ( >0.05). The operation time, intraoperative blood loss, postoperative drainage, hospitalization time, incision healing, and complications were recorded and compared. The acetabular abduction and anteversion were measured on the X-ray films; prosthesis loosening was observed. The VAS score, HHS score, and hip ROM were used to evaluate the hip function.

RESULTS

The operation time and intraoperative blood loss of group A were significantly higher than those of group B, and the hospitalization time was significantly lower than group B ( <0.05), but no significant difference was found in postoperative drainage between 2 groups ( =0.71, =0.46). The patients were followed up 2-2.5 years (mean, 2.2 years) in group A, and 2-2.5 years (mean, 2.1 years) in group B. In group A, 3 cases had lateral femoral cutaneous nerve traction injury and 1 case had swelling and exudate, and primary healing of incision was obtained in the other cases of group A and all cases of group B. No periprosthetic joint infection occurred in the others of groups A and B except 1 case of group A at 2 months after operation, and infection was controlled after debridement, irrigation, and intravenous infusion of Vancomycin for 1 month. The X-ray films showed good position of prosthesis and no obvious radiolucent line or prosthesis loosening. There was no significant differences in acetabular abduction and anteversion between groups A and B at last follow-up ( >0.05). The VAS score, HHS score, and hip ROM at 3 months and last follow-up were significantly better than preoperative ones in 2 groups ( <0.05), but no significant difference was found between at 3 months and last follow-up ( >0.05). The VAS score, HHS score, and hip ROM in group A were significantly better than those in group B at 3 months postoperatively ( <0.05). At last follow-up, the hip ROM in group A was significantly better than that in group B ( <0.05), and there was no significant difference in VAS and HHS scores between group A and group B ( >0.05).

CONCLUSION

The short-term effectiveness of minimally invasive THA by DAA is satisfactory, with the advantage of little trauma, short hospital stay, and rapid postoperative recovery.