Clinical Outcomes of DAMIS Traction Table-Assisted Anterior Approach versus Posterolateral Approach on Total Hip Arthroplasty in the Treatment of Femoral Head Necrosis

Abstract

AIM: Femoral head necrosis often leads to hip joint dysfunction, which can be effectively treated with total hip arthroplasty (THA). This study compares the clinical outcomes of direct anterior minimally invasive surgery (DAMIS) traction table-assisted anterior approach and the traditional posterolateral approach (PLA) on THA for femoral head necrosis.

METHODS: A total of 150 patients with femoral head necrosis, admitted between September 2019 and May 2022, were included in this study. In this sample, 68 patients underwent THA via the PLA (control group), while the remaining 82 patients were treated with THA using the DAMIS traction table-assisted anterior approach (observation group). The surgical-related indicators, postoperative pain scores, Harris hip scores (HHS), and rates of complication incidence between the two groups were compared.

RESULTS: There were no significant differences in surgery time between the two groups (p = 0.054). The observation group had significantly less intraoperative blood loss (p = 0.018), shorter incision length (p = 0.001), and significantly shorter time elapsed to first out-of-bed activity (p = 0.016) and shorter hospital stay compared to the control group (p = 0.001). The postoperative pain scores in the observation group were significantly lower than in the control group (p = 0.001), and the HHS at 2 weeks and 4 weeks after surgery were significantly higher in the observation group (p < 0.05). The overall complication rate in the observation group was significantly lower than in the control group (p = 0.011).

CONCLUSIONS: DAMIS traction table-assisted anterior approach for THA demonstrates clinical advantages in the treatment of femoral head necrosis, effectively accelerating postoperative recovery and reducing the occurrence of complications.