小切口与传统切口金属对金属大头全髋关节置换术疗效对比分析

Comparative study of clinical effect on minimal incision and traditional incision in large diameter metal-on-metal total hip arthroplasty

目的对比小切口与传统切口金属对金属大头(L-MoM)全髋关节置换术(THA)的临床疗效。方法由同一组手术医生行小切口L-MoM THA12例(小切口组),传统切口L-MoM THA10例(传统切口组)。平均随访时间12个月。比较两组的切口长度、手术时间、总失血量、住院时间、术后髋臼及股骨假体的位置及术后12个月Harris评分,记录术后并发症、疼痛情况及患者满意度。结果小切口组的切口长度、总失血量、住院时间均优于传统切口组(P<0.05)。小切口组术后疼痛情况轻,患者对切口外观的满意度较高。两组均未发生术后并发症。两组患者手术时间、髋臼角度测量及术后12个月Harris评分比较,差异均无统计学意义(P>0.05)。结论小切口L-MoM THA可取得与传统切口L-MoM THA相当的疗效,且损伤小、出血少、恢复快。

Objective To compare the clinical effect of minimal incision with traditional incision in large diameter metal- on-metal （L-MoM） total hip arthroplasty （THA）. Methods All operations were performed by the same surgeons with L- MoM. Twelve cases were performed with minimal incision, and 10 cases with traditional incision. The average follow-up peri- od was 12 months. The Operative time, incision length, total blood loss, length of hospitalization, componen malposition, complications, postoperative harris hip score, pain and patients＇ satisfaction were compared between the two groups. Results Statistically significant differences were found in two groups in terms of incision length, total blood loss, length of hospitalization. The minimal incision group was better than traditional incision group （P〈0.05）. Moreover records showed less pain and more satisfaction with the appearance of incision in minimal incision group. There were no significant differences between the two groups with regard to operative time, major complications, component malposition and harris hip score （P〉0.05）. Conclusion The minimal incision L-MoM THA can resume the ideal function of the hip joint as well as the traditional incision and has advantages of less invasive and blood loss, rapidly postoperative recovery of function.