改良Hardinge小切口髋关节置换术

Minimal incision hip replacement through the modified Hardinge approach

目的探讨改良Hardinge小切口入路髋关节置换术的可行性。方法2005年7月-2006年3月，采用以大转子为中心改良Hardinge小切口对21例22个髋关节行髋关节置换术。12例13髋行全髋关节置换，9例行双极股骨头置换，均采用生物型假体。结果手术切口平均长7．6cm（6．0—9．0cm），手术时间平均76min（45-150min），术中出血量平均370ml（190—580m1）。无严重并发症。21例平均随访38周（22—53周），Hams评分优18例19髋，良3例，优良率100％。结论改良Hardinge小切口髋关节置换术对关节的稳定性影响小，手术显露清楚，安全可行。

Objective To investigate the feasibility of hip replacement through a minimal incision via modified Hardinge approach. Methods Hip replacement was performed in 21 cases （22 hip joints） from July 2005 to March 2006. The operation was completed through a minimal incision via modified Hardinge approach, with the greater trochanter as the center. There were 12 cases of total hip replacement （ 13 hip joints） and 9 cases of bipolar femoral head replacement. A biological prosthesis was used in all the cases. Results The mean length of incision was 7.6 cm （ range, 6.0-9.0 cm） , the mean operation time was 76 min （range, 45-150 min）, and the mean blood loss, 370 ml （range, 190-580 ml）. No severe complications occurred. All the cases were followed for a mean of 38 weeks （range, 22 - 53 weeks）. Evaluation with the Harris hip score system showed excellent outcomes in 18 cases （19 hips） and good in 3 cases, with a rate of excellent or good results of 100%. Conclusions Minimal incision hip replacement through the modified Hardinge approach has advantages of minimal trauma, little blood loss, low complication rate, and quick recovery.