Comparison of the early results of the treatment of developmental dysplasia of hip with the lateral approach and the posterior lateral approach total hip arthroplasty

Abstract

Objective To investigate the early clinical effect of lateral decubitus position direct anterior approach(DAA) for primary total hip arthroplasty(THA) in the treatment of developmental dysplasia of hip(DDH). Methods A retrospective study was performed on 56 cases of DDH patients who were admitted from September 2015 to September 2016.According to different approaches, patients were divided into the DAA group(n=28) and the posterolateral approach(PLA) group(n=28). The follow-up time ranged from 7 to 15 months(average 9.2 months). Statistics of the two groups with incision length, operative time, intraoperative blood loss, postoperative drainage, total blood loss, ambulation time and hospitalization days, VAS pain score of 1, 3, 5, 7 days after operation, Harris hip score of 3, 7 days, 1, 3, 6 months after surgery, the incidence of postoperative complications were analyzed. Results There was no significant difference in operative incision length and operation time between the DAA group and the PLA group(P>0.05). The intraoperative blood loss, postoperative drainage, total blood loss, the activity time and the average hospital stay of DAA group were less than those of PLA group(P 0.05); the VAS scores of 1, 3, 5 and 7 days in the DAA group were smaller than those in the PLA group(P<0.05). Two patients had posterior dislocation of the PLA group. Conclusion The DAA of THA has the advantages of less pain, less bleeding, strong anti dislocation ability, rapid recovery; at the same time, the DAA of THA doesn′t need special operation bed, simple disinfection, it has the same position with PLA, which will not increase the difficulty of surgery because of changes in position, shorten the learning curve. Key words: Hip arthroplasty; Lateral decubitus position; Direct anterior approach; Posterolateral approach; Developmental dysplasia of hip