全髋关节置换术直接前路与后外侧入路临床结果的比较

Comparison of Clinical Outcomes of Total Hip Arthroplasty with Direct Anterior and Posterolateral Approaches

目的:比较DAA和PLA入路下髋关节置换术的临床效果。方法:回顾性分析我院2017年1月至2020年11月于我院行全髋关节置换术的患者。根据入路不同,分为DAA组和PLA组。观察围手术期血红蛋白、HHS评分、VAS评分、手术时间、切口长度等指标。结果:(1)与PLA组相比,DAA组手术当天Hb(血红蛋白)进一步下降(P<0.001),术后第4天和第5天Hb下降(P<0.001),以及术后2周Hb下降(P=0.021)。在其他时间点,两组间ΔHb(某一时间点的血红蛋白与术前血红蛋白的差值)差异无统计学意义。(2)DAA组在手术时间、切口长度、住院时间等方面优于PLA组;DAA组早期HSS评分和VAS评分优于PLA组。结论:全髋关节置换术采用直接前入路(DAA),早期功能恢复较快,远期效果与后外侧入路(PLA)无明显差异。

Objective:To compare the clinical effects of hip arthroplasty via DAA and PLA approaches.Methods:Retrospective analysis of patients who underwent total hip arthroplasty in our hospital from January 2017 to November 2020.They were divided into DAA PLA group according to different approaches.To observe perioperative hemoglobin,HHS score,VAS score,operation time,incision length and other indicators.Results:(1)Compared with the PLA group,the DAA group had a further decrease in Hb(hemoglobin)on the day of surgery(P<0.001),a decrease in Hb on postoperative days 4 and 5(P<0.001),and a decrease in Hb 2 weeks after surgery(P=0.021).At other time points,there was no significant difference in ΔHb(difference in prehemoglobin at a certain time point between the two groups).(2)DAA group was superior to PLA group in terms of operation time,incision length and hospital stay;DAA group was superior to PLA group in terms of early HSS score and VAS score.Conclusion:Direct anterior approach(DAA)for total hip arthroplasty has a faster early functional recovery,and the long-term effect is not significantly different from that of posterolateral approach(PLA).