小切口与标准切口全髋关节置换术早期疗效的比较

A Comparative Study of Early Postoperative Effect of Primary Total Hip Arthroplasty with A Mini-incision or A Standard Incision

目的探讨小切口全髋关节置换术的合理性。方法回顾性分析2002年11月～2005年12月,进行单侧全髋关节置换术的116例资料。小切口组53例,切口长度≤10cm;对照组(标准切口)63例,切口长度11～17cm。记录患者身高、体重、年龄、手术时间、切口长度、术中出血量、围手术期输血量、髋臼假体外展角、股骨柄假体角度,分别测量手术前后Harris评分。结果两组资料患者年龄,性别、术前诊断及HHS评分均无显著性差异。平均体重指数小切口组小于对照组。术中平均失血量小切口组小于对照组,平均手术时间、围手术期输血量及术后HHS评分两组间无显著差异。两组髋臼假体及股骨柄假体位置良好,组间比较无显著性差异。结论对于技术熟练的手术者,应用小切口技术进行全髋关节置换安全、有效。与传统切口全髋关节置换比较,除可减少术中出血量外,单纯小切口在术后早期未能表现出明显优点。

Objective To compare the short- term results of primary total hip arthroplasty performed with a mini- incision or a standard incision, and explore the rationality for mini - incision technique. Methods A consecutive series of patients who underwent 116 primary unilateral total hip replacements between November 2002 and December 2005 were studied. Patients were divided into two groups according to the length of the incision at the end of surgery. Incisions of 10 cm or less were defined as ＂mini＂ （n= 53）, incisions longer than 10 cm were defined as ＂standard＂ and served as the controls （n= 63）. In- hospital data were collected retrospectively, and the initial postoperative radiographs were analyzed. Results No significant differences were detected between the groups with respect to the average surgical time, postoperative hematocrit, in- hospital blood transfusion requirements, postoperative Harris hip score. There was no difference in the cup abduction angle and femoral stem alignment between the two groups. The mini - incision group was found to have a slightly less intraoperative blood loss. Conclusion Total hip arthroplasty can be performed safely and effectively through a mini-incision, but this investigation failed to confirm that this procedure offers significant benefit in the early postoperative period compared with a standard incision.