[Effect of minimally invasive anterior lateral approach for total hip arthroplasty on serum type I collagen propeptide, tartrate-resistant acid phosphatase 5b and hip joint function in patients with femoral neck fracture]

Abstract

Objective: To analyze the level of serum N-terminal propeptide of type I precollagen (PINP) and tartrate resistant acid phosphatase 5b(TRACP-5b) in patients with femoral neck fracture(FNF) after minimally invasive anterior lateral approach with total hip arthroplasty and the effects of hip function.

Methods: From September 2016 to May 2017, 98 cases of femoral neck fracture were divided into control group and observation group, 49 cases in each group. There were 49 patients in control group, including 30 males and 19 females, ranging in age from 63 to 72 years old, who underwent minimally invasive anterolateral total hip arthroplasty. There were 49 patients in observation group, including 29 males and 20 females, ranging in age from 62 to 73 years old, who underwent minimally invasive anterolateral total hip arthroplasty. The perioperative conditions(operation time, bleeding volume, incision length, hospitalization time), bone metabolism indexes including PINP, TRACP-5b, fibroblast growth factor(FGF), bone gla-protein(BGP), propetide carboxy-terminal procollagen (PICP), bone-specific alkaline phosphatase(BAP), and pain mediators such as prostaglandin E2 (PGE2) and 5-hydroxytrytamine (5-HT) levels were compared between the two groups. The hip joint function and complications were evaluated.

Results: The operation time of the observation group was longer than that of the control group(P<0.05); there was no significant difference in bleeding volume, incision length and hospitalization time between two groups(P>0.05). PINP, fibroblast growth factor, BGP, PICP and BAP in observation group were higher than those in control group 1 month after operation, and TRACP-5b was lower than those in control group(P<0.05); PGE2 and 5-HT in observation group 1 month after operation were lower than those before operation, and lower than those in control group(P<0.05). The excellent and good rate of hip function in observation group was higher than that in control group (P<0.05), and the incidence of complications was not significantly different from that in the control group (P>0.05).

Conclusions: Minimally invasive anterolateral approach total hip arthroplasty is safe and reliable, and can improve hip function, improve bone metabolism, promote fracture healing, alleviate pain in patients with femoral neck fracture, which is worthy of promotion.

Keywords: Arthroplasty, replacement, hip; Femoral neck fractures; Fracture healing; Minimally invasive surgical procedures.