Total hip arthroplasty via direct anterior approach in treatment of ankylosed hips

doi:10.3877/cma.j.issn.1674-134X.2020.03.004

Abstract

Abstract:

Objective

To evaluate the clinical outcomes of total hip arthroplasty via direct anterior approach in the treatment of ankylosed hips.

Methods

A retrospective analysis was performed on the data of 62 patients (66 hips) treated with total hip arthroplasty for ankylosed hips from October 2015 to October 2018 in Fujian Provincial Hospital. The patients with ankylosing spondylitis and hip arthritis were included and the patients with severe spinal deformity were excluded. According to the surgical approach, the patients were divided into direct anterior approach group and posterolateral approach group. The incision length, bleeding volume, Harris score and X-ray evaluation were used to evaluate the hip function of the two groups. Chi-square test was performed in count data and t test was used for measurement data.

Results

No significant differences were found in incision length and bleeding volume between the two groups(t=1.346, 1.272, both P>0.05). In the latest follow-up for an average of (25±11) months, all patients were relieved of pain. In the direct anterior approach group, the preoperative average Harris score was (61±14)and the postoperative average score was (97.8±2.9). In the posterolateral approach group, the preoperative average Harris score was (59.3±14.3)and the postoperative average score was (97.4±3.3). The postoperative average Harris score was significantly superior to the preoperative average score in both two groups (t=14.229, 14.729, P<0.001). However, there was no significant differences between the two groups (t=0.416, P>0.05). There was no osteolysis and loosening signs in X-ray in both two groups and no complication was found during the follow-up.

Conclusion

The clinical outcomes of total hip arthroplasty via direct anterior approach in the treatment of ankylosed hips are satisfactory.

Key words: Arthroplasty, replacement, hip, Spondylitis, ankylosing, Arthrodesis

Licheng Guo, Jie Xu. Total hip arthroplasty via direct anterior approach in treatment of ankylosed hips[J]. Chinese Journal of Joint Surgery(Electronic Edition), 2020, 14(03): 280-285.

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Figures/Tables 6

References 20

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分组	例数	性别(男/女)	病种(例)		年龄[岁，(±s)]	身体质量指数[kg/m²，(±s)]	病史[年，(±s)]	Harris髋关节评分(±s)
分组	例数	性别(男/女)	髋关节融合	严重髋关节炎	年龄[岁，(±s)]	身体质量指数[kg/m²，(±s)]	病史[年，(±s)]	Harris髋关节评分(±s)
直接前入路组	30	28/2	24	6	40±10	26±5	14±7	61±14
后外侧入路组	32	29/3	21	11	41±10	26±4	17±9	59±14
统计值	?	χ²＝0.006	χ²＝0.967		t ＝0.397	t ＝0.752	t ＝1.573	t ＝0.391
P值	?	>0.05	>0.05		>0.05	>0.05	>0.05	>0.05

分组	例数	性别(男/女)	病种(例)		年龄[岁，(±s)]	身体质量指数[kg/m²，(±s)]	病史[年，(±s)]	Harris髋关节评分(±s)
分组	例数	性别(男/女)	髋关节融合	严重髋关节炎	年龄[岁，(±s)]	身体质量指数[kg/m²，(±s)]	病史[年，(±s)]	Harris髋关节评分(±s)
直接前入路组	30	28/2	24	6	40±10	26±5	14±7	61±14
后外侧入路组	32	29/3	21	11	41±10	26±4	17±9	59±14
统计值	?	χ²＝0.006	χ²＝0.967		t ＝0.397	t ＝0.752	t ＝1.573	t ＝0.391
P值	?	>0.05	>0.05		>0.05	>0.05	>0.05	>0.05

分组	例数	切口长度(cm)	术中出血(ml)
直接前入路组	33	8.4±1.8	237.9±92.7
后外侧入路组	33	8.9±1.7	271.4±122.0
t值	?	1.346	1.272
P值	?	>0.05	>0.05

分组	例数	切口长度(cm)	术中出血(ml)
直接前入路组	33	8.4±1.8	237.9±92.7
后外侧入路组	33	8.9±1.7	271.4±122.0
t值	?	1.346	1.272
P值	?	>0.05	>0.05

组别	例数	时段	疼痛	功能	查体	总分
直接前入路组	30	术前	22.3±6.8	31.8±9.3	6.6±1.2	60.7±14.0
直接前入路组	?	术后	42.4±2.0	46.5±1.3	8.8±0.5	97.8±2.9
t值	?	?	15.534	8.612	9.659	14.229
P值	?	?	<0.01	<0.01	<0.001	<0.001
组别	例数	时段	疼痛	功能	查体	总分
后外侧入路组	32	术前	20.9±6.9	31.7±9.5	6.6±1.2	59.3±14.3
后外侧入路组	?	术后	42.5±2.0	46.3±1.7	8.7±0.7	97.4±3.3
t值	?	?	17.022	8.545	8.385	14.729
P值	?	?	<0.01	<0.01	<0.001	<0.001

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