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| The Application Value of Lateral Position Direct Anterior Approach Total Hip Arthroplasty in Developmental Dysplasia of the Hip Joint |
| ZHANG Lichao, WU Di, et al |
| Chengde Medical University Affiliated Hospital, Hebei Chengde 067000,China |
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Abstract Objective: To investigate the efficacy of direct anterior approach total hip arthroplasty in the treatment of developmental dysplasia of the hip in the lateral decubitus position and to observe changes in postoperative spinal-pelvic X-ray images. Methods: A total of 82 patients with DDH who underwent total hip arthroplasty in the Department of Joint Surgery of the Affiliated Hospital of Chengde Medical University from June 2015 to June 2022 were retrospectively analyzed. According to the different surgical approaches, they were divided into a direct anterior approach group and a posterolateral approach group. The age, hip joint classification, gender, affected side, incision length, operation time, hospital stay, postoperative drainage volume, and complications of the two groups were compared. The Harris hip score and visual analogue scale (VAS) score of patients in the direct anterior approach group and the posterolateral approach group were recorded preoperatively, 3d,14d postoperatively, and 1, 3,12and 24 months postoperatively, and the hip abduction and flexion angles were measured. The changes of sacrum tilt angle, iliac tilt angle, and hip joint tilt angle were measured on standing position X-ray film before and 1 month after operation. Results: There were statistically significant differences in incision length, operation time, hospital stay, postoperative drainage volume, and complications between the two groups (P<0.05), and DAA group had better results than PLA group. The changes of hip Harris score, VAS score, hip abduction and flexion angle in the direct anterior approach group and posterolateral approach group at different time points before and after operation were statistically significant (P<0.05). The hip Harris score, hip abduction and flexion angle in the two groups after operation were significantly increased compared with those before operation, and the postoperative VAS score was significantly decreased compared with those before operation. After total hip arthroplasty, the sacral tilt angle, iliac tilt angle and hip joint tilt angle of the two groups were significantly lower than those before operation (P<0.001). There was no significant difference in Harris score, VAS score, hip abduction, and flexion angle between the direct anterior approach group and the anterolateral approach group at different time points before and after operation (P > 0.05). Conclusion: The direct anterior approach total hip arthroplasty in the lateral decubitus position demonstrates significant efficacy in treating developmental dysplasia of the hip and improves pelvic tilt in patients with developmental dysplasia of the hip.
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2025, Vol. 31 
