“两切口”微创入路与后外侧小切口入路全髋关节置换6年后的比较研究

Comparison study on total hip replacements with “two-incision”minimally-invasive approach and small-incision-posterolateral approach six years after surgery

目的回顾性比较研究"两切口"微创入路与后外侧小切口入路全髋关节置换的中期治疗效果。方法对符合入组条件的患者,"两切口"微创置换组15例、后路小切口置换组17例于手术后6年进行Harris评分,并于Cybex 2000检测设备上行髋关节屈曲、后伸、外展、内收、内旋、外旋的肌力测试,将结果统计分析。结果 Harris评分"两切口"微创置换组(91.2±4.3)分(n=15),后路小切口置换组(93.5±4.8)分(n=17),两组间无统计学差异(P>0.05)。随访所有患者髋关节后伸、外展、内收、内旋、外旋的肌力测试,"两切口"组(n=15)分别平均是:(41.7±8.2)Nm,(17.6±5.2)Nm,(36.2±2.8)Nm,(12.9±4.1)Nm,(1.4±1.3)Nm;后外侧小切口组(n=17)分别是:(38.4±4.1)Nm,(18.4±2.6)Nm,(5.3±3.4)Nm,(14.8±3.7)Nm,(1.7±0.5)Nm,两组间无统计学差异(P>0.05)。髋关节屈曲肌力,"两切口"微创置换组是(21.2±4.3)Nm,小于后路小切口置换组(33.3±5.9)Nm(P<0.05)。结论 "两切口"微创入路与后外侧小切口入路全髋关节置换中期治疗效果的主要指标无统计学差异。

Objective To evaluate the mid-term clinical results of ＂two-incision＂ minimally- invasive total hip replacement （MIS-THR） comparing with the small incision posterolateral approach THR retrospectively. Methods Six years after the operation, 15 patients of ＂two-incision＂ MIS-THR group and 17 patients of small incision posterolateral approach THR group were qualified and enrolled. Harris score was evaluated. The muscle strength of hip flexion, extension, abduction, adduction, internal rotation and external rotation were measured by Cybex 2000 machine. Results The average Harris score of ＂two- incision＂ MIS-THR group was （91.2 ± 4. 3 ） （n = 15 ）, and that of the small incision posterolateral approach THR group was （93.5± 4. 8 ） （ n = 15 ）, （ P 〉 0. 05 ）. There was no statistic difference in Harris score between the two groups （ P 〉 0. 05 ）. The average muscle strength of hip extension, abduction, addtuetion, internal rotation and external rotation in ＂two incision＂ group （n = 15） were as follows： （41.7±8.2）Nm, （17.6±5.2） Nm, （36.2±2.8） Nm, （12.9±4.1） Nm, and （1.4±1.3） Nm respectively; while in the small incision posterolateral approach THR group （n = 17 ） , the data were as follows： （38.4±4.1） Nm, （18.4±2.6） Nm, （5.3±3.4） Nm, （14.8±3.7） Nm, and （1.7±0.5） Nm respectively. There was no statistical difference between the two groups （ P 〉 0.05 ）. The strength of hip flexion in ＂two-incision＂ MIS-THR group （21.2±4. 3 Nm） was inferior to that of the small incisionposterolateral approach THR group （ 33.3 ± 5.9 Nm） （ P 〈 0. 05 ）. Conclusion There is no obvious difference in mid-term clinical results between ＂ two-incision ＂ MIS-THR and the small incision posterolateral approach THR.