外侧小切口全髋关节置换术疗效的初步评价

Preliminary assessment of total hip arthroplasty using lateral mini-incision

目的评价外侧小切口全髋关节置换术的临床疗效。方法将2003年8月至2006年2月进行外侧小切口全髋关节置换术的36例患者(40髋,小切口组)与同期进行外侧传统全髋关节置换术的40例患者(40髋,传统手术组)作对比研究,评估损伤程度、术后恢复情况及并发症发生情况。结果小切口组切口长度、手术时间和下地负重时间均显著短于传统手术组(P值分别<0.01、0.05),术中失血量、输血量、术后引流量及术后1周疼痛发生率均明显小于传统手术组(P值均<0.05)。小切口组术后1、6个月患髋Harris评分均明显高于传统手术组(P值均<0.05)。传统手术组术后发生切口延迟愈合2例,下肢深静脉栓塞1例,假体脱位1例;小切口组无任何并发症发生。结论与传统全髋关节置换术比较,外侧小切口全髋关节置换术具有外形美观、创伤小、出血量少、术后恢复快和术后并发症少等优点,但需注意选择合适的患者。

Objective To evaluate the clinical outcome of hybrid prosthesis total hip arthroplasty（THA） using lateral minimal incision. Methods From August 2003 to February 2006, 36 patients （40 hips） were performed THA using lateral mini-incision and were compared with 40 patients（40 hips） performed THA using traditional lateral approach to assess degree of damage, postoperative recovery, and incidence of complications between the two groups. Results There were significant difference between the＂ two groups in terms of incisional length, operative and operative blood loss, operation duration, pain occurring one week after operation and duration of postoperative ambulation. At 1 month follow-up, the Harris score of mini-incision THA group was 88.6 ± 4.5 and 75.6 ± 3.6 for the traditional group（P 〈 0.05）. At 6 months follow-up, the Harris score of mini-incision THA group was 95.3 ± 3.2 and 90.5 ± 3.8 for the traditional group（P 〈 0.05）. There were 2 cases of delayed union, 1 symptomatic DVT and 1 prosthesis dislocation occurred in the traditional group but no complication occurred in the mini-incision THA group. Conclusions THA using lateral mini-incision is an ideal technique with advantage of shorter incisional length, less soft tissue damage, less blood loss, less complications and faster recovery. But selection of suitable patients for mini-incision THA should be noticed.