关键词: 全髋关节置换术, 微创直接前入路, SuperPATH入路, 平衡, 功能恢复

Abstract: Objective To investigate the difference between the minimally invasive direct anterior approach(DAA) and the SuperPATH approach for early balance and functional recovery after total hip arthroplasty(THA).Methods A total of 82 patients with THA who were admitted to the Eastern Theater General Hospital from August 2016 to August 2020 were divided into DAA group(minimally invasive DAA approach for THA) and SuperPATH group(SuperPATH approach) according to the random number table.THA),41 cases in each group.The acetabular angles(anterior angle,abduction angle) of the two groups of patients were compared with operation related indicators on the 3rd postoperative day.Two groups of patients before operation(T0),1 week after operation(T1),1 month after operation(T2),3 months after operation(T3) and 6 months after operation(T4) Berg Balance Scale(BBS) The score was compared with the Harris score of hip joint function.The postoperative complications of the two groups of patients were compared.Results The length of incision in SuperPATH group [(6.83±0.72) vs(8.06±0.84) cm],intraoperative blood loss [(61.54±10.08)ml vs(80.23±15.74) ml] was shorter(less) than that in DAA group(P<0.05),The operation time [(125.13±11.27)min vs(115.76±10.8 5) min] was longer than that in the DAA group(P<0.05).The postoperative drainage volume [(70.25±11.36)ml vs(65.87±10.43) ml] of the two groups of patients was compared,and the difference was not statistically significant(P>0.05).The anteversion angle of the acetabulum [(15.72±1.76)° vs(15.96±1.85)°] and the abduction angle [(43.28±3.56)° vs(42.75±3.19)°] were compared between the two groups of patients after surgery,and the difference was not statistically significant(P>0.05).There were statistically significant differences in BBS scores between groups,time,and interaction(P<0.05).There was no significant difference in BBS scores between the two groups at T0(P>0.05).Compared with T0,the BBS scores of the two groups of patients at T1,T2 and T3 were reduced(P>0.05),and at T1 [(38.25±5.42)points vs(34.86±6.08) points],T2 time [(41.25±4.96)points vs(37.17±4.03) points],the BBS score of the SuperPATH group was higher than that of the DAA group(P>0.05).There was no significant difference in BBS scores between the two groups at T3 and T4(P>0.05).There were statistically significant differences in the Harris scores of hip joint function between groups,time,and interaction(P<0.05).There was no significant difference in Harris scores of hip joint function between the two groups at T0(P>0.05).Compared with T0,the Harris scores of hip joint function of the two groups of patients at T1,T2,T3,and T4 increased(P>0.05),and T1 [(66.92±3.87)minutes vs(62.35±3.29) minutes],T2 [(77.85±4.06)points vs(75.02±3.75) points] The Harris score of hip joint function in SuperPATH group was higher than that in DAA group(P>0.05).There was no significant difference in Harris scores of hip joint function between the two groups at T3 and T4(P>0.05).The incidence of complications in the SuperPATH group and DAA group were 4.88% and 9.76%,respectively,and the difference was not statistically significant(P>0.05).Conclusion Compared with minimally invasive DAA,the SuperPATH approach for THA has a shorter incision length and less intraoperative blood loss.The two approaches for THA have better early balance and functional recovery,and both are safe and reliable.

Key words: total hip replacement, minimally invasive direct anterior approach, SuperPATH approach, balance, functional recovery