Clinical Trials Study
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 26, 2019; 7(24): 4226-4233
Published online Dec 26, 2019. doi: 10.12998/wjcc.v7.i24.4226
Dissection and ligation of the lateral circumflex femoral artery is not necessary when using the direct anterior approach for total hip arthroplasty
Gong-Yin Zhao, Yu-Ji Wang, Nan-Wei Xu, Feng Liu
Gong-Yin Zhao, Yu-Ji Wang, Nan-Wei Xu, Department of Orthopedics, The Affiliated Changzhou NO. 2 People’s Hospital of Nanjing Medical University, Changzhou 213003, Jiangsu Province, China
Feng Liu, Department of Orthopedics, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210000, Jiangsu Province, China
Author contributions: Liu F designed research; Zhao GY, Wang YJ, and Xu NW performed research; Zhao GY and Wang YJ analyzed data; Zhao GY wrote the paper.
Institutional review board statement: The approval for this study was obtained from the Institutional Review Board committees of the affiliated Changzhou NO. 2 People’s Hospital of Nanjing Medical University.
Clinical trial registration statement: The clinical trial was registered in the affiliated Changzhou NO. 2 People’s Hospital of Nanjing Medical University, with the registration number of 2016-c-06-01.
Informed consent statement: Informed consent was obtained from all individual participants included in the study.
Conflict-of-interest statement: The authors declare that there is no conflict of interest.
Data sharing statement: We declare that data from this experiment can be shared in a public database.
CONSORT 2010 statement: The design and composition of the clinical trials study conform to the CONSORT2010 statements.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Feng Liu, MD, PhD, Chief Doctor, Department of Orthopedics, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing 210000, Jiangsu Province, China. njliuf@163.com
Telephone: +86-15961104432
Received: August 17, 2019
Peer-review started: August 17, 2019
First decision: September 23, 2019
Revised: October 20, 2019
Accepted: November 19, 2019
Article in press: November 19, 2019
Published online: December 26, 2019
Processing time: 129 Days and 21.7 Hours
ARTICLE HIGHLIGHTS
Research background

Direct anterior approach total hip arthroplasty is widely accepted and becoming more and more popular all over the world. More orthopedists have switched from posterior to anterior approaches. Although the procedure is generally the same, no consensus has been reached on some details.

Research motivation

In the direct anterior approach, there are different opinions on the treatment of the ascending branch of the lateral femoral circumflex artery. The hope is that these studies will lead to a consensus on some of the details of direct anterior approach total hip arthroplasty.

Research objectives

Whether ligation of the ascending branch of the lateral femoral circumflex artery during direct anterior approach total hip arthroplasty is advantageous in reducing bleeding and whether this procedure is necessary.

Research methods

The manuscript compared the surgical bleeding, hemoglobin reduction, hematoma rate, and other indicators of two groups that received different treatments for the ascending branch of the lateral femoral circumflex artery during direct anterior approach total hip arthroplasty.

Research results

According to the results, the ligation of the ascending branch of the lateral femoral circumflex artery was not a necessary procedure. Electrocautery is a simple and effective method. However, due to the small sample size and short follow-up time, further observation is needed to see whether there is any difference between the two treatment methods.

Research conclusions

The intraoperative and postoperative blood loss were calculated to indirectly reflect vascular bleeding. Excision of the ascending branch of the lateral femoral artery by electrocautery did not increase bleeding. In the treatment of the ascending branch of the lateral circumflex femoral artery, cumbersome ligation can be replaced by electrocoagulation.

Research perspectives

Ligation is unnecessary and should be replaced by electrocautery in the treatment of the lateral circumflex femoral artery during the direct anterior approach total hip arthroplasty.