小切口微创人工全髋关节置换47例

Minimally invasive total hip arthroplasty in 47 cases

选择2006-07/2008-04泸州医学院附属医院骨与关节外科收治的初次行人工全髋关节置换患者103例(107髋)。按置换方法不同分为2组:微创组47例47髋:股骨头坏死15例15髋,股骨颈骨折28例28髋,骨性关节炎4例4髋,采用改良后外侧切口、非骨水泥假体人工全髋关节置换;常规置换组56例60髋:按传统全髋关节置换方法进行;记录置换过程中、置换后出血量、切口长度、疼痛、关节功能恢复情况、住院时间,观察围手术期并发症。103例患者均获得随访,其中微创组随访3～11个月;常规置换组随访7～22个月。微创组置换过程中、置换后平均出血量少于常规置换组(P<0.05);常规置换组1例置换后发生深静脉栓塞,微创组无并发症发生;微创组随访3个月时Harris评分为(87.0±4.2)分,与常规置换组(89.0±3.8)分相近(P>0.05);提示微创组置换后关节功能恢复较快,疼痛轻,平均住院时间短于常规置换组。

From July 2006 to April 2008, 103 patients （107 hips） undergoing first total hip arthroplasty （THA） were selected from Department of Bone and Joint Surgery, Affiliated Hospital of Luzhou Medical College. According to treatment methods, minimally invasive group （47 cases, 47 hips） including 15 cases （15 hips） of necrosis of the femoral head, 28 cases （28 hips） of femoral neck fracture, and 4 cases （4 hips） of osteoarthfitis, were treated with small posterior skin incision and cementless prosthesis; the routine group （56 cases, 60 hips） underwent routine THA. The blood loss, incision length, pain, functional recovery, length of stay, and perioperative complications were recorded. 103 patients were followed up, of which minimally invasive THA was followed up for 3 11 months, and routine group followed up for 7-22 months. In the minimally invasive THA group, the patients had less blood loss （P 〈 0.05） and postoperative drainage with no complication. Deep venous embolism occurred in one case of routine group. There was no significant difference between minimally invasive and routine groups in postoperative Harris scores （87.0±4.2, 89.0±3.8, P 〉 0.05）. The results show that minimally invasive THA has the advantages of less complication, shorter hospital stay, slighter pain and faster function recovery compared to routine THA.