改良后外侧小切口全髋关节置换手术技术

Techniques of mini-incision total hip arthroplasty using improved posterolateral approach

目的探讨后外侧入路行小切口全髋关节置换术的技术方法及注意事项。方法通过对207例后外侧入路小切口全髋关节置换术手术技术、方法进行总结，规范其手术技术操作和不同髋关节疾病手术注意事项。结果本手术方式各操作步骤规范、合理，术中显露充分、准确，手术切口长度平均（7.4±1.3）cm；手术时间（64.4±20.6）min（最短32min），术中出血量（365±154）ml，术后引流量（151±65）ml。随访时间6-26个月（平均11.8个月），随访期内X线未见假体位置不良。Harris评分术后较术前明显提高：术前（48.0±11.7）分，术后（85.0±7.6）分。结论后外侧小切口全髋关节置换术具有创伤小、切口美观、围手术期出血少、术中术后并发症少及术后早期功能恢复快的优点，通过规范的技术操作步骤和针对不同髋关节疾病注意事项的妥善处理，可以达到比传统方法更优异的近期疗效。

Objective To introduce the techniques of mini-incision total hip arthroplasty （THA） with the improved posterolateral approach. Methods Standardize the techniques and surgery attentions of different hip diseases were summed up 207 cases of mini-incision total hip arthroplasty （THA） with the posterolateral approach. Results Each operation steps was regular and reasonable.Exposure in the operation was adequate and accurate. The average length of surgical incisions was （7.4±1.3） cm. These cases were performed with mean surgery time of （64.4±20.6） min （minimum 32 minutes）. Blood loss during operation was （365±154） ml. Drainage after the operation was （151±65） ml. All patients were followed-up for 6～26 months（mean 11.8 months）.The postoperation radiography all showed good position of the prosthetic components. Harris score after operation markedly improved： preoperative （48.0±11.7） points and postoperation （85.0±7.6） points. Conclusion Posterolateral mini-incision total hip arthroplasty was proved to be successful in reducing surgical trauma and perioperative bleeding, accelerating rehabilitation and decreasing complications. We could achieve much better recent curative effect than traditional methods through standardized technical steps and the proper handling to attention of different hip diseases.