Chen Liyile, Sun Shuo, Wang Qiuru, Bahete Aergen, Cai Lijun, Kang Pengde
Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu, China.
HSS J. 2023 May;19(2):172-179. doi: 10.1177/15563316221145688. Epub 2023 Jan 12.
Controversies remain on the best surgical approaches for unilateral total hip arthroplasty (THA). There are little data on simultaneous bilateral THA via direct anterior approach (SimBDAA-THA) or posterolateral approach (SimBPA-THA). : We sought to assess differences in perioperative outcomes and early medical and surgical complications between SimBDAA-THA and SimBPA-THA. : This retrospective study involved patients who underwent either SimBDAA-THA in a supine position (n = 73) or SimBPA-THA in a lateral position (n = 162) at our institution from January 2015 to November 2021. The 2 groups were compared in terms of clinical and demographic characteristics, surgical parameters, and complications during 6-months of follow-up. : There were no differences in clinical and demographic characteristics between the 2 groups prior to surgery. Simultaneous bilateral THA via direct anterior approach significantly shortened the length of both the operation (117.50 ±19.42 vs 143.97 ± 32.20 min) and the hospitalization (140.64 ± 43.22 vs 156.24 ± 56.64 h) but increased perioperative loss of hemoglobin (3.28 ± 1.01 vs 3.21 ± 2.26 g/dL). There were no significant differences between the two groups in transfusion rate; levels of interleukin-6, C-reactive protein or creatine kinase; or complications. : This retrospective study of patients at a single institution found minimal differences in perioperative outcomes or early medical and surgical complications between SimBDAA-THA and SimBPA-THA except operative time and length of hospitalization. Larger studies with longer follow-up should be conducted to identify whether a direct anterior approach is superior to a posterolateral one.
对于单侧全髋关节置换术（THA）的最佳手术入路仍存在争议。关于经直接前路同时进行双侧THA（SimBDAA - THA）或经后外侧入路同时进行双侧THA（SimBPA - THA）的数据很少。我们试图评估SimBDAA - THA和SimBPA - THA在围手术期结果以及早期医疗和手术并发症方面的差异。这项回顾性研究纳入了2015年1月至2021年11月在我们机构接受仰卧位SimBDAA - THA（n = 73）或侧卧位SimBPA - THA（n = 162）的患者。对两组患者的临床和人口统计学特征、手术参数以及随访6个月期间的并发症进行了比较。两组患者术前的临床和人口统计学特征没有差异。经直接前路同时进行双侧THA显著缩短了手术时间（117.50 ± 19.42对143.97 ± 32.20分钟）和住院时间（140.64 ± 43.22对156.24 ± 56.64小时），但增加了围手术期血红蛋白损失（3.28 ± 1.01对3.21 ± 2.26 g/dL）。两组在输血率、白细胞介素 - 6、C反应蛋白或肌酸激酶水平以及并发症方面没有显著差异。这项对单一机构患者的回顾性研究发现，除了手术时间和住院时间外，SimBDAA - THA和SimBPA - THA在围手术期结果或早期医疗和手术并发症方面差异极小。应该进行更大规模、更长随访时间的研究，以确定直接前路是否优于后外侧入路。
