Tianjin Medical Journal

Tianjin Medical Journal ›› 2021, Vol. 49 ›› Issue (9): 977-980.doi: 10.11958/20210726

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Comparative analysis of the early efficacy of hemiarthroplasty by direct anterior approach and posterolateral approach

REN Qiu-xiao1, ZHOU Jia-bin2, TAN Hao-wen2, CUI Guan-xing2, HAN Gui-quan2△, ZHANG Yu-ying1   

  1. 1 School of Clinical Medicine, Weifang Medical University, Weifang 261042, China; 2 Department of Joint Surgery, Affiliated Hospital of Weifang Medical University
  • Received:2021-03-29 Revised:2021-05-21 Published:2021-09-15 Online:2021-09-18

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Abstract: Abstract: Objective　To compare and analyze the early clinical efficacy of direct anterior approach (DAA) and posterolateral approach (PLA) in hemiarthroplasty for aged patients with femoral neck fractures. Methods　A total of 90 aged patients with femoral neck fractures treated with hemiarthroplasty were divided into DAA group (42 cases) and PLA group (48 cases) according to different surgical approaches. The postoperative general data, visual analog scale (VAS) before operation and 1 d, 3 d and 5 d after operation, Harris hip function score (HHS) before operation and 1 w, 1 month, 3 months and 6 months after operation were compared between the two groups. The hip abductor torque, Berg balance scale (BBS), joint position sensation (JPS) angle and the Trendelenburg’s sign were compared and analyzed between the two groups at 1 week, 1 month, 3 months and 6 months postoperatively. Results　The operation time was longer in the DAA group than that in the PLA group, but the incision length, intraoperative blood loss and the decrease in hemoglobin (Hb) on the first day after operation were less in the DAA group than those in the PLA group (P＜0.01). The HHS score and torque of the two groups increased with time, while the VAS and angles of JPS decreased. The HHS and torque of the DAA group were higher than those of the PLA group, while the VAS and JPS angles of the DAA group were lower than those of the PLA group. Trendelenburg's sign in the DAA group was superior to that in the PLA group at each time point. The incidence of complications in the DAA group (2.4%) was lower than that in the PLA group (4.2%), with no significant difference (P＞0.05). Conclusion　DAA has less operative trauma, and faster postoperative rehabilitation in hip joint function and proprioception, which contribute to the speedy recovery of patients. The early efficacy of DAA is better than that of PLA.

Key words: femoral neck fracture, arthroplasty, replacement, hip, proprioception, aged, joint function, direct anterior approach, posterolateral approach