前侧及后外侧入路髋臼假体安放位置的比较

Effect of total hip arthroplasty with different approaches on accuracy of acetabular prosthesis

目的探讨前侧入路和后外侧入路全髋关节置换术对髋臼假体位置准确性的影响。方法选择2017年1月至2018年4月在四川省巴中骨科医院初次接受单侧人工全髋关节置换的91例患者作为研究对象,根据手术入路不同将患者分为前侧入路组47例和后外侧入路组44例。观察两组髋臼假体外展角、前倾角和股骨偏心距。组间计量资料比较采用独立样本t检验,率的比较采用卡方检验。结果前侧入路组外展角、前倾角与后外侧入路组相比较均显著升高(t=5.082,4.327),差异均有统计学意义(均为P<0.05)。前侧入路组外展角、前倾角可接受率高于后外侧入路组(t=6.773,3.931),差异有统计学意义(均为P<0.05);前侧入路组股骨偏心距可接受率高于后外侧入路组,但差异无统计学意义(t=1.556,P>0.05)。结论直接前侧入路人工全髋关节置换可提高髋臼假体前倾角和外展角可接受率,改善髋臼假体位置准确性。

Objective To study the effect of total hip arthroplasty with different approaches on the accuracy of acetabular prosthesis.Methods Ninety-one patients receiving total hip replacement in Bazhong Orthopaedic Hospital from January 2017 to April 2018 were selected as the research objects,and the patients were divided into the anterior approach group(47 cases)and the posterolateral approach group(44 cases)according to the operative approach.The abduction angle and anteversion of acetabular prosthesis and femoral offset of two groups were observed.Independent-t test was used to compare the measurement data between two groups,and chi-square test was used for enumeration data.Results The abduction angle and anteversion angle in the anterior approach group were significantly higher than those in the posterolateral approach group,and the difference was statistically significant(t=5.082,4.327 respectively,both P<0.05).The acceptance rate of abduction angle and anteversion angle of the anterior approach group was higher than that of the posterolateral approach group,and the difference was statistically significant(t=6.773,3.931 respectively,both P<0.05).The acceptability of femoral eccentricity in the anterior approach group was higher than that in the posterolateral approach group,but the difference was not statistically significant(t=1.556,P>0.05).Conclusion The total hip arthroplasty through direct anterior approach can improve the acceptability of acetabular prosthesis anteversion and abduction angle,and improve the accuracy of acetabular prosthesis.