全髋关节初次置换微创前外侧手术入路的现状

Current Status and Progress of Minimally Invasive Anterolateral Approach for Primary Total Hip Arthroplasty

近年来,微创全髋关节置换术逐步成熟,多种入路在初次人工全髋关节置换中应用广泛。微创前外侧入路从肌间隙进入,对软组织的干扰小。该入路出血少,术后康复快、后期瘢痕小。与传统及其他微创入路相比优势明确,但也有视野小、器械要求高、学习曲线长等不足。目前在切口、解剖定位标记及假体设计上已有新的尝试。远期来看该术式符合患者的期望,潜力较大。如能结合计算机导航辅助、3D打印技术及进一步开展骨组织的微创,应用前景更加广阔。

In recent years,the minimally invasive total hip arthroplasty is getting matured gradually.Many different approaches have been widely used in primary total hip arthroplasty.The antero-lateral minimally invasive(ALMI)approach which enters through myocutaneous space has several benefits,Including:little interference with the soft tissue,less bleeding,quick recovery after operation and small scar in later stage.Compared with the traditional and other minimally invasive approaches,the advantages of ALMI are clear,but there are also shortcomings,such as small fields of vision,high requirements for apparatus and long learning curves.New attempts have been made in incisional,anatomical location markers and prosthesis design.In the long term,the approach meets the patients′expectations and has great potential.If combining computer navigation assistance with 3D printing technology and further development of minimally invasive procedure of bone tissue,we believe that ALMI has the potential for broader application.