Analysis of the effect of posterior lateral approach and direct anterolateral approach total hip arthroplasty in treating geriatric femoral neck fractures
Objective To analyze the effect of posterior lateral approach and direct anterolateral approach total hip arthroplasty in treating geriatric femoral neck fractures.Methods A total of 42 patients with femoral neck fractures admitted to the first people's hospital of shangqiu city from February 2019 to December 2023 were selected as the research subjects and divided into the posterior lateral approach group and the direct anterolateral approach group,with 21 patients in each group.The patients in the posterior lateral approach group underwent posterior lateral approach total hip arthroplasty,while the patients in the direct anterolateral approach group underwent direct anterolateral approach total hip arthroplasty.The chan-ges in perioperative indicators(operation time,incision size,blood loss,hospital stay,drainage volume)were observed in the two groups of patients;the degree of pain and hip function were evaluated by visual analog scale(VAS)and Harris hip score;the oxidative stress indicators glutathione peroxidase,superoxide dismutase,and malondialdehyde in the blood were detected by kit;the inflammatory factors interleukin-1 β,interleukin-10,and tumor necrosis factor in the blood were analyzed by enzyme-linked immunosorbent assay.Quantitative data between groups were compared by t-test.Results The surgical incision,blood loss,hospital stay and safe weight-bearing time of patients in the direct anterior approach group[(8.16±0.79)cm,(201.14±19.78)ml,(5.10±1.14)d,(32.43±2.68)d]were significantly lower than those in the posterolateral approach group[(8.16±0.79)cm,(201.14±19.78)ml,(6.57±1.25)d,(40.52±3.64)d,t=8.265.3.845,4.009,8.210,P＜0.05].The operation time in the direct anterior approach group[(90.33±5.65)min]was significantly higher than that in the posterolateral approach group[(82.80±5.28)min,t=4.459,P＜0.05].The visual analogue pain score in the direct anterior approach group[(3.00±0.89)points]was significantly lower than that in the posterolateral approach group[(4.71±1.06)points,t=5.678,P＜0.05].The Harris score in the direct anterior approach group[(87.19±4.07)points]was significantly higher than that in the posterolateral approach group[(77.23±5.23)points,t=6.879,P＜0.05].The activities of superoxide dismutase and glutathione peroxidase in the direct anterior approach group[(100.33±8.99),(576.95±58.77)U/ml]were signifi-cantly higher than those in the posterolateral approach group[(77.10±8.95),(435.19±56.54)U/ml,t=8.395,7.798,P＜0.05].The level of malondialdehyde in the direct anterior approach group[(5.69±0.48)mmol/L]was significantly lower than that in the posterolateral approach group[(7.42±0.57)mmol/L,t=10.630,P＜0.05].The serum levels of interleukin-1 β and tumor necrosis factor A in the direct anterior approach group[(52.29±7.40),(82.90±8.89)ng/ml]were significantly lower than those in the posterolateral approach group[(73.71±6.97),(100.33±7.16)ng/ml],and the difference was statistically significant(t=9.565,6.999,P＜0.05).Conclusion Direct anterior approach total hip arthroplasty for the treatment of femoral neck fractures in elderly patients demonstrates significant efficacy,with minimal surgical trauma and lower postoperative oxidative stress and inflammation levels.This ap-proach helps alleviate patient pain and facilitates joint function recovery.
Posterolateral approachDirect anterior approachTotal hip arthroplastyFemo-ral neck fractureOxidative stressInflammatory response
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