微创小切口人工全髋关节置换术对股骨头坏死的临床疗效分析

Clinical Effect of Minimally Invasive Small Incision Artificial Total Hip Arthroplasty on Femoral Head Necrosis

目的通过对比分别接受开放手术与微创小切口手术的股骨头坏死患者的临床疗效与术后髋关节功能恢复情况,为此类疾病的治疗以及临床手术方式的改进提供依据。方法方便选取该院骨科2015年5月—2017年5月间收治的120例股骨头坏死的患者作为该研究的研究对象,将120例患者随机分为实验组与对照组,分别接受微创小切口人工全髋关节置换术与传统髋关节全置换手术,对比两组患者术后Harries关节功能评分以及并发症的发生情况。结果对照组60例患者中共5例出现了术后并发症,其中3例为术后感染,2例出现严重疼痛,无人出现假体植入失败。实验组仅1例出现术后感染。Fisher确切概率法的结果显示两组并发症发生率差异有统计学意义(P=0.01)。实验组与对照组均于术后30 d接受Harries髋关节功能评分,实验组的平均得分为(87.92±4.67)分,对照组平均分为(76.87±5.01)分,差异有统计学意义(t=312.49,P=0.00)。按照Harries得分标准分类之后,实验组评分优秀者46例,良好12例,尚可1例,较差1例。对照组人数分布分别为22例、26例、2例、12例,差异有统计学意义(χ2=8.08,P=0.00)。可认为实验组术后关节功能恢复好于对照组。结论可认为使用微创小切口人工全髋关节置换术对于股骨头坏死需置换髋关节的患者具有良好的临床效果,并且可以有效降低术后并发症的发生,有利于提升术后髋关节的功能恢复效果。

Objective By comparing the clinical efficacy and hip function recovery of patients with femoral head necrosis after open surgery and minimally invasive small incision surgery respectively, it provides a basis for the treatment of such diseases and the improvement of clinical surgical methods. Methods A total of 120 patients with femoral head necrosis treated between May 2015 and May 2017 in this hospital were convenient selected as the study subjects. 120 patients were randomly divided into experimental group and control group and received minimally invasive surgery. Incisional total hip arthroplasty and conventional total hip arthroplasty were performed to compare the postoperative harries joint function scores and the incidence of complications. Results In the control group, 60 patients had 5 postoperative complications, of whom 3 were postoperative infections and 2 had severe pain. No implant failure occurred. Only one patient in the experimental group developed postoperative infection. The results of Fisher＇s exact probability method showed a statistically significant difference in the incidence of complications between the two groups（P=0.01）. Both the experimental group and the control group received the Harries hip function score 30 days after the operation. The mean score of the experimental group was（87.92±4.67）points, and the mean score of the control group was（76.87±5.01）points. The difference was statistically significant（t =312.49, P =0.00）. After classification according to the criteria of Harries scoring, the experimental group scored 46 excellent, 12 cases were good, 1 cases was fair, and 1 cases was poor. The distribution of the control group was 22 cases, 26 cases, 2 cases and 12 cases（χ2=8.08, P=0.00）. The difference was statistically significant, which can be considered experimental group joint function recovery better than the control group. Conclusion It can be considered that the use of minimally invasive small incision artificial total hip arthroplasty for hip replacement necrosis of the femoral head necrosis patients have a good clinical effect, and can effectively reduce postoperative complications, is conducive to improve the functional recovery of hip joint after surgery effect.