Total hip arthroplasty for senile femoral neck fractures: Superpath approach versus traditional posterolateral approach
10.3969/j.issn.2095-4344.2750
- Author:
Zhengxia HU
1
Author Information
1. Department of Orthopedics, Affiliated Hospital of Chengdu University
- Publication Type:Journal Article
- Keywords:
Elderly;
Femoral neck fracture;
Posterolateral approach;
SuperPATH approach;
Total hip arthroplasty
- From:
Chinese Journal of Tissue Engineering Research
2020;24(24):3834-3839
- CountryChina
- Language:Chinese
-
Abstract:
BACKGROUND: In recent years, there are many minimally invasive approaches for total hip arthroplasty. CHOW et al. operated the total hip arthroplasty with SuperPATH approach (supercapsular percutaneously assisted total hip arthroplasty) in 2010, which has the characteristics of not cutting off extortor and retaining the hip joint capsule. This approach is beneficial to early postoperative activities for patients, and has a lower risk for hip joint dislocation compared with other approaches. OBJECTIVE: To compare and analyze the short-term clinical outcomes of SuperPATH and traditional posterolateral total hip arthroplasty in the treatment of senile femoral neck fractures. METHODS: This study retrospectively analyzed 72 patients aged over 65 years old with femoral neck fractures from August 2017 to March 2019 in Affiliated Hospital of Chengdu University. The patients were grouped according to patients’ wishes. Of them, 30 cases received total hip arthroplasty through SuperPATH approach; 42 cases received total hip arthroplasty through posterolateral approach. Operation time, intraoperative blood loss, declined value of hemoglobin in 4 days of postoperation and time to weight-bearing activity were recorded between two groups. Hip Harris score after 1, 2 weeks and 3 months postoperation was used to assess the recovery of hip function. RESULTS AND CONCLUSION: (1) All patients were followed up for 3-6 months. (2) In the second week after operation, all the patients were discharged without complications such as deep vein thrombosis, sciatic nerve injury, periprosthetic fracture, periprosthetic loosening or periprosthetic infection. In the posterolateral approach group, there were two patients with posterior dislocation of the hip, all of whom were treated by manual reduction under general anesthesia. (3) Compared with the posterolateral approach group, operation time was longer; the declined value of hemoglobin in 4 days of postoperation was significantly lesser; time to weight-bearing activity was earlier in the SuperPATH approach group (P < 0.01). However, intraoperative blood loss was not significantly different between the two groups (P > 0.05). (4) Harris score was significantly higher in the SuperPATH approach group than in the posterolateral approach group at 1 and 2 weeks after operation (P < 0.01). Harris score was not significantly different between the two groups at 3 months (P > 0.05). (5) It is concluded that total hip arthroplasty through SuperPATH approach is a minimally invasive operation, can effectively reduce surgical injury, accelerate hip function recovery, and reduce the postoperative pain and discomfort of hip joint and the incidence of dislocation of hip joint in the treatment of senile femoral neck fractures compared with posterolateral approach. Nevertheless, because of the difficulty of operation, the long learning curve and the prolongation of operation time, intraoperative blood loss has not been significantly reduced. The operation by experienced surgeons can effectively reduce the incidence of complications.
