فهرست نشریات علمی دسترسی آزاد ایران

Background and Objectives: Total hip arthroplasty (THA) is the main modality for the treatment of femoral neck fractures, but the traditional surgical approach has certain safety risks, and finding a more effective surgical approach can help to improve the outcome of THA for femoral neck fractures. In this study, we compared the clinical efficacy of THA through the direct anterior approach (DAA) and the anteromedial approach (AMA) in the treatment of femoral neck fractures to provide a clinical reference.   Methods: From August 2020 to February 2023, 120 patients with femoral neck fractures who underwent THA were randomized into DAA group and AMA group with the procedure performed through DAA and AMA, respectively. The surgical conditions and postoperative complications of the two groups were counted. Pain assessment was made using the Visual Analogue Scale (VAS), and hypersensitive C-reactive protein (hs-CRP) and creatine kinase (CK) levels were measured. Patients’ prognoses were followed up for 6 months, and their range of motion (ROM) of the hip joint was measured.   Results: DAA and AMA groups were not statistically different in the incidence of complications (P>0.05); the incision length, intraoperative bleeding, postoperative drainage volume, and hospital stay were lower in DAA group compared with AMA group, while the operation time was longer (Ps<0.05); DAA group had lower postoperative hs-CRP and CK levels and milder pain than AMA group (P<0.05). Prognostic follow-up showed no difference in ROM and imaging findings between the two groups (P>0.05).   Conclusion: Compared with AMA-THA, DAA-THA for femoral neck fractures is less traumatic and contributes to faster postoperative rehabilitation and less pain and stress inflammation.