Comparison of one-stage bilateral total hip arthroplasty between SuperPATH approach and posterolateral approach based on enhanced recovery after surgery

doi:10.12307/2021.319

Abstract

Abstract: BACKGROUND: With the gradual deepening of the concept of enhanced recovery after surgery, orthopedists have put forward higher requirements for the efficacy of total hip replacement. The traditional posterolateral surgical approach is traumatic, with slow postoperative recovery. Minimally invasive total hip replacement surgery provides a new option for orthopedic surgeons.
OBJECTIVE: To compare the clinical effects of Supercapsular Percutaneously-Assisted Total Hip (SuperPATH) approach and conventional posterolateral approach for one-stage bilateral total hip arthroplasty.
METHODS: A retrospective study was conducted on 25 patients (50 hips) with one-stage bilateral total hip arthroplasty in the First Affiliated Hospital of Soochow University from April 2016 to April 2018. In terms of surgical approach conducted, 12 patients (24 hips) had total hip arthroplasty performed by SuperPATH approach, while remaining 13 patients (26 hips) underwent total hip arthroplasty with posterolateral approach. The length of incision, operation time, intraoperative blood loss, postoperative blood transfusion, hemoglobin difference, and length of stay were compared between the two groups. Harris score (pain, function, deformity, range of motion), visual analogue scale score and complications were compared between the two groups after surgery. The differences in abduction angle, anteversion angle, and length of both lower limbs were compared between the two groups.
RESULTS AND CONCLUSION: (1) All the patients entered in the enhanced recovery after surgery management process during the perioperative period. Totally 25 patients had operation performed smoothly. (2) Comparison of the related indexes of the two sets of approaches showed that SuperPATH approach group had smaller surgical incision, less postoperative blood transfusion, and less hemoglobin difference compared with the posterolateral approach group (P < 0.05). However, operation time was longer in the SuperPATH approach group (255.17±38.57) minutes than that in the posterolateral approach group (188.15±30.84) minutes (P < 0.01). (3) The Harris score of SuperPATH approach group at 3 and 7 days after operation was significantly higher than that in the posterolateral approach group (P < 0.05). The visual analogue scale score at 1 and 3 days after operation was significantly lower in SuperPATH approach group compared to the posterolateral approach group (P < 0.05). (4) There was no statistically significant difference in the length of lower limps, anteversion and abduction angle of the acetabular prosthesis (P > 0.05). (5) The results show that under the guidance of the concept of enhanced recovery after surgery, SuperPATH minimally invasive in phase I bilateral total hip arthroplasty was safe and effective, with advantages of shorter incision length, less postoperative blood transfusion, less recessive blood loss, faster hip function recovery and less pain.

Key words: total hip arthroplasty, one-stage bilateral, SuperPATH approach, minimally invasive, posterolateral approach, enhanced recovery after surgery

CLC Number:

Zhang Weicheng, Li Rongqun, Wu Mingzhou, Zheng Kai, sun houyi, Zhang Lianfang, Zhou Jun, Xu Yaozeng. Comparison of one-stage bilateral total hip arthroplasty between SuperPATH approach and posterolateral approach based on enhanced recovery after surgery[J]. Chinese Journal of Tissue Engineering Research, 2021, 25(33): 5312-5317.

Figures/Tables 8

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