前外侧入路微创人工全髋关节置换术的临床研究

Clinical Application and Research of Minimally Invasive Anterolateral Muscle Sparing Approach Total Hip Arthroplasty

目的探讨前外侧入路微创全髋关节置换术的优缺点及适应症。方法自2006年2月-2008年10月运用前外侧入路进行微创全髋关节置换术51例,并与同期按常规后外侧切口完成的51例THA在手术时间、出血量、切口长度、围手术期并发症、术后Harris评分及影像学评价等方面进行比较。结果前外侧入路组患者在切口长度、总失血量及术后1个月Harris评分比较有统计学差异(P<0.01);而手术时间、髋臼杯外展角、前倾角、髋臼-假体黏附率、股骨-假体三点固定率无统计学差异(P>0.05)。结论前外侧肌间隙入路具有单一切口内完成髋臼和股骨假体安装、不需要透视、不剥离任何肌肉附着点的优点,早期功能恢复快;但要有严格的手术指征,熟练的手术操作技术和专用的器械。

Objective To investigate the advantages and indications of minimally invasive anterolateral muscle sparing approach total hip arthroplasty. Methods From February 2006 to October 2008, the 51 cases of the total hip arthroplasty operation with anterolateral muscle sparing approach were compared with 51 cases of the total hip arthroplasty operation with posterolateral approach in random. observing operative time, blood loss, incision length, complications, post -operative Harris hip score and imaging evaluation. Results Statisdically significant differences were found in two groups in terms of incision length, total blood loss and Harris hip score 1 month later. There was no remarkable difference between the two groups in the aspect of operative time and prosthetic position. Conclusion By using minimal invaslve anterolateral muscle sparing approach, acetabular and femeral stem are implanted in single small incision without fluorescence imaging and muscle attachment striping Early function recovery can be achieved. It is feasiblc with strict indication, adequate surgical training and use of specialized Instrumentation.