在后入路人工髋关节置换术中保留并修复后方关节囊及韧带的效果探究

Study on the effect of preserving and repairing the posterior capsule and ligament in posterior approach hip arthroplasty

目的:探讨在后入路人工髋关节置换术中保留并修复后方关节囊及韧带的临床效果。方法:选取2016年1月至2019年10月期间在贵州医科大学第三附属医院骨科接受后入路人工髋关节置换术的72例患者作为研究对象。将这72例患者分为对照组(n=36)和观察组(n=36)。对对照组患者在进行后入路人工髋关节置换术中不保留和修复后方关节囊及韧带。对观察组患者在进行后入路人工髋关节置换术中保留并修复后方关节囊及韧带。然后,比较两组患者髋关节恢复功能的评分、手术持续的时间、术中的出血量、术后并发症的发生率及髋关节后脱位的发生率。结果:接受治疗后,观察组患者手术持续的时间短于对照组患者,其术中的出血量少于对照组患者;出院当天、术后1个月及术后3个月,观察组患者髋关节恢复功能的评分均高于对照组患者;术后1个月及术后3个月,观察组患者髋关节后脱位的发生率均低于对照组患者,P<0.05。接受治疗后,两组患者均未出现异物排斥反应、感染等术后并发症。结论:在后入路人工髋关节置换术中保留并修复后方关节囊及韧带的临床效果较好,且安全性较高,可有效地缩短患者手术持续的时间,减少其术中的出血量,降低其髋关节后脱位的发生率,改善其髋关节的功能。

Objective:To investigate the clinical effect of the posterior capsular and ligament repair in posterior approach hip arthroplasty.Methods:72 patients who received posterior approach hip arthroplasty in the department of Orthopedics,The Third Affiliated Hospital of Guizhou Medical University from January 2016 to October 2019 were selected as study subjects.The 72 patients were divided into control group(n=36)and observation group(n=36).In the control group,the posterior capsule and ligament were not retained and repaired during the posterior approach hip arthroplasty.In the observation group,posterior capsular and ligaments were retained and repaired during posterior approach hip arthroplasty.Then,the score of hip recovery,duration of surgery,intraoperative blood loss,incidence of postoperative complications,and incidence of posterior dislocation of the hip were compared between the two groups.Results:After treatment,the duration of operation in the observation group was shorter than that in the control group,and the amount of bleeding in the operation was less than that in the control group.On the day of discharge,1 month after surgery and 3 months after surgery,the hip joint recovery scores of patients in the observation group were all higher than those in the control group.1 month and 3 months after the operation,the incidence of posterior dislocation of hip joint in the observation group was lower than that in the control group(P<0.05).After treatment,there were no postoperative complications such as foreign body rejection and infection in the two groups.Conclusion:The retention and repair of posterior capsule and ligament in posterior approach hip arthroplasty has a good clinical effect and a higher safety,which can effectively shorten the duration of surgery,reduce intraoperative blood loss,reduce the incidence of posterior dislocation of the hip,and improve the function of the hip joint.