Abstract：Objective This study aims to explore the clinical efficacy of total hip arthroplasty (THA) via direct anterior approach (DAA) for the treatment of high dislocation type developmental dysplasia hip (DDH). Methods A retrospective analysis was conducted on the clinical data of eight patients (one male and seven females aged [61.86±8.49] years, seven Crowe Ⅲ cases, seven hips and one Crowe Ⅳ, one hip) with Crowe Ⅲ-Ⅳ DDH who underwent THA through DAA approach in the First Affiliated Hospital of Bengbu Medical College from June 2016 to October 2019. The length of incision, operation time, intraoperative bleeding volume, stay earlier out-of-bed activity, length of hospital stay, and surgical complications were observed. The abduction angle and antegrade hip angle of acetabular cup were measured at 1 week after operation. Differences in the length of lower limbs, Harris score, and center-edge(CE) angle of hip joint were compared before operation, 1 week after operation, and the last follow-up. Results The length of incision, operative time, intraoperative bleeding volume, stay earlier out-of-bed activity, and length of hospital stay were (7.56±0.62)cm, (108±17.65) min, (205±47.20) mL, (3.25±0.88)d, and (5.50±0.76)d, respectively. The acetabular cup abduction angle and anteversion angle at 1 week after operation were 41.40°± 4.03° and 17.90°±3.27° respectively, which were in the Lewinnek safe range. The length difference, Harris score, and CE angle were (3.98±0.47) cm, (43.38±9.65) points, and 15.86°±2.20°, respectively, before operation, and (0.85±0.25) cm, (80.63±4.37) points, and 37.29°±2.21°, respectively, 1 week after operation and (0.81±0.20) cm, (80.50±4.75) points, and 37.17°±2.07°, respectivly, the last follow-up (F=597.814、40.866、150.145, all P values＜0.01). No significant difference in the length difference, Harris score, and CE angle was found between the two lower limbs at 1 week after operation and at the last follow-up (all P values＞0.05). In this group, one case of lateral femoral cutaneous nerve injury symptom was noted. No femoral fracture, hip dislocation, sciatic nerve injury, lower limb deep venous thrombosis, and other severe complications were reported. Conclusions The DAA approach is safe and can achieve good clinical effect for the treatment of patients with high dislocation type hip dysplasia.
吴一凡, 周新社, 裴立家. 直接前方入路全髋关节置换术治疗高脱位型髋关节发育不良的临床应用[J]. 中华解剖与临床杂志, 2021, 26(2): 188-192.
Wu Yifan, Zhou Xinshe, Pei Lijia. Clinical application of direct anterior approach for total hip arthroplasty as a treatment of high dislocation type hip dysplasia. Chinese Journal of Anatomy and Clinics, 2021, 26(2): 188-192.
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2021, Vol. 26 
