Data_Sheet_1_Conversion of a Fused or Ankylosed Hip to Total Hip Arthroplasty: Is the Direct Anterior Approach in the Lateral Decubitus Position an Ideal Solution?.DOCX

BackgroundTotal hip arthroplasty (THA) using the direct anterior approach (DAA) is becoming increasingly popular due to its potential benefits over the posterolateral approach (PLA). However, few studies have compared the efficacies of these two surgical approaches in hip fusion treatment. This study compared early clinical direct anterior and posterolateral THA outcomes in hip fusion treatment.MethodsHere, 127 hips (65 DAA, 62 PLA) were retrospectively evaluated. Early postoperative functional outcomes of DAA and PLA groups were assessed using Harris score and Oxford Hip Score (OHS) and standard anteroposterior hip radiographs. Surgical characteristics, perioperative results, and complications within 6 months postoperatively were recorded.ResultsThough baseline values were similar, Harris and OHS scores were better in the DAA group than in the PLA group at 1 and 3 months postoperatively. The average cup anteversion angle was significantly greater in the DAA group than in the PLA group (12.7° vs. 11.1°). More hips undergoing DAA were successfully orientated in both inclination and anteversion angles (46 vs. 32). Early postoperative hip function predictors were preoperative fused hip position, surgical approach, and range of motion. DAA was associated with reduced postoperative blood loss and shorter hospital stays. Furthermore, 14 vs. 8 complications occurred in the DAA vs. PLA group. Lateral femoral cutaneous nerve injuries were observed in eight hips (12.3%) of the DAA group.ConclusionFor fused or ankylosed hips, THA using DAA in the lateral decubitus position may result in excellent prosthesis positioning and faster postoperative recovery throughout early follow-up vs. PLA.

背景：由于直接前入路（DAA）相较于后外侧入路（PLA）在潜在益处方面的优势，全髋关节置换术（THA）采用DAA正日益受到青睐。然而，关于这两种手术入路在髋关节融合治疗中的疗效比较的研究寥寥无几。本研究对比了早期临床直接前入路和后外侧入路THA在髋关节融合治疗中的结果。方法：在此，对127个髋关节（65个DAA，62个PLA）进行了回顾性评估。使用Harris评分和牛津髋关节评分（OHS）以及标准前后位髋关节X光片评估了DAA和PLA组的早期术后功能结果。记录了手术特征、围术期结果和术后6个月内的并发症。结果：尽管基线值相似，但在术后1个月和3个月时，DAA组的Harris和OHS评分均优于PLA组。DAA组的平均杯前倾角显著大于PLA组（12.7° vs. 11.1°）。在倾斜和前倾角度上，进行DAA手术的髋关节成功定位的案例更多（46 vs. 32）。早期术后髋关节功能预测因素包括术前融合髋关节位置、手术入路和活动范围。DAA与术后出血减少和住院时间缩短相关。此外，DAA组与PLA组相比，并发症发生率为14 vs. 8。在DAA组的8个髋关节（12.3%）中观察到股外侧皮神经损伤。结论：对于融合或强直的髋关节，侧卧位采用DAA进行THA可能在早期随访期间相较于PLA实现更佳的假体定位和更快的术后恢复。