Comparison of early functional recovery between direct anterior minimally invasive surgery and posterolateral approach for total hip arthroplasty in the treatment of femoral neck fracture in the elderly
Li Junran1, Li Ligeng1, Zhai Jingxiu2, Luo Cheng1, Liu Hongyang1, Zhang Hongbin1, Kong Qinghai1, Liang Junsheng1
1Department of Geriatric Orthopedics, Tangshan Second Hospital, Tangshan 063000,China; 2Department of Internal Medicine, Tangshan Second Hospital, Tangshan 063000, China
Abstract：Objective This study aims to compare and analyze the early clinical effect of direct anterior minimally invasive surgery (DAMIS) and the posterolateral approach (PLA) for total hip arthroplasty (THA) on the treatment of geriatric patients suffering from femoral neck fracture . Methods A retrospective study was conducted. A total of 171 femoral neck fracture patients who were treated with THA in Tangshan Second Hospital from October 2017 to September 2018 were included. Among the patients, 89 received DAMIS THA (DAMIS group); these patients included 41 males and 48 females aged between 61 and 78 years, with an average age of (68.63±4.35) years. Another 82 patients received THA through PLA (PLA group), and these included 36 males and 46 females aged between 62 and 76 years, with an average age of (67.93±3.49) years. The operative time, intraoperative blood loss, postoperative duration in bed, and Harris scores of the two groups within 1 week, 2 weeks, 1 month, 3 months, 6 months, and 12 months after surgery were recorded and compared. Results No significant difference was found among age, gender, body mass index (BMI), and other general information of the two groups (all P values＞0.05). The intraoperative blood loss (208.09±23.45) mL and postoperative duration in bed (0.55±0.62) days of the DAMIS group were significantly less than those of the PLA group ([293.66±43.45] mL and [1.56±0.93] days), there were statistical differences (t=16.198, 8.406, all P values＜0.01). The Harris scores of the DAMIS group, namely, (72.66±4.87), (76.71±4.13), and (81.94±4.73), were significantly higher than those of the PLA group with (61.38±7.61), (68.13±6.16), and (74.06±5.16) within 1 week, 2 weeks, and 1 month after operation (t=11.446, 10.600, 10.431, all P values＜0.01). Conclusions Compared with PLA-THA, DAMIS-THA has less blood loss, shorter postoperative duration in bed, and faster postoperative enhanced recovery in the treatment of geriatric patients suffering from femoral neck fracture. The optimal early clinical effect of DAMIS deserves affirmation.
李骏然, 李力更, 翟婧秀, 罗程, 刘弘扬, 张洪斌, 孔庆海, 梁俊生. 微创直接前侧入路与后外侧入路全髋关节置换术治疗老年人股骨颈骨折的早期临床疗效对照研究[J]. 中华解剖与临床杂志, 2021, 26(2): 182-187.
Li Junran, Li Ligeng, Zhai Jingxiu, Luo Cheng, Liu Hongyang, Zhang Hongbin, Kong Qinghai, Liang Junsheng. Comparison of early functional recovery between direct anterior minimally invasive surgery and posterolateral approach for total hip arthroplasty in the treatment of femoral neck fracture in the elderly. Chinese Journal of Anatomy and Clinics, 2021, 26(2): 182-187.
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