SuperPATH微创入路全髋关节置换术在治疗股骨头无菌性坏死中的应用

Application of Super PATH approach in mini-invasion total hip replacement for aseptic necrosis of femoral head

目的评价Super PATH微创入路全髋关节置换术治疗股骨头无菌性坏死的临床疗效。方法选取采用Super PATH微创入路全髋关节置换术(Super PATH组)和常规入路髋关节置换术(常规组)治疗的股骨头无菌性坏死患者各8例,比较两组患者手术切口长度、术中出血量、术后48h引流量、手术时间、住院时间、术后髋臼外展角、前倾角测量值、术后并发症发生情况和手术前后Harris评分。结果所有患者术后均获得随访,随访时间6~10个月。Super PATH组患者手术切口长度、术中出血量、术后48h引流量、手术时间均优于常规组(均P<0.05)。两组患者Harris评分均呈逐渐上升趋势,差异均有统计学意义(均P<0.05);两组患者术后不同时间点Harris评分比较差异均有统计学意义(均P<0.05)。两组患者术后均未出现关节脱位、骨折、创面及关节感染、双下肢不等长、跛行、深静脉血栓等并发症。结论 Super PATH微创入路全髋关节置换术在治疗股骨头无菌性坏死中具有术中出血量少、手术切口小、手术时间短、利于术后髋关节功能恢复等优势;符合现代快速康复的理念,值得广大关节外科医师学习。

Objective To evaluate the clinical efficacy of SuperPATH approach in mini-invasive total hip arthroplasty foraseptic necrosis of femoral head. Methods Sixteen patients with aseptic necrosis of femoral head were treated with mini-invasivetotal hip replacement, including8 cases with SuperPATH approach（SuperPATH group） and8 cases with conventional approach（control group）. Incision length, the intraoperative blood loss, post-operation drainage, duration of surgery, time of hospitalization,postoperatively obliquity, abduction angle measurement, postoperative complications and the Harris scores before and afteroperation were compared between two groups. Results All patients were followed up for 6-10 months. The intraoperative bloodloss, post-operation drainage were less, the incision length and duration of surgery were shorter in SuperPATH group than thosein the control group（all P〈0.05）. The Harris scores were improved significantly after surgery in both groups（both P〈0.05）;however, the Harris scores at same time points in SuperPATH group were better than those in the control group（all P〈0.05）.There were no complications such as joint dislocation, infection, sciatic nerve injury and deep venous thrombosis observed afteroperation in the two groups. Conclusion The SuperPATH has advantages of less bleeding and smaller incision, shorter operationtime and faster recovery of hip joint function for patients with mini-invasion total hip replacement for aseptic necrosis of femoralhead.