直接前方入路全髋关节置换术治疗强直性髋关节炎的效果

Effect of total hip replacement via direct anterior approach in the treatment of ankylosing arthritis of hip

目的探讨直接前方入路全髋关节置换术(THR)治疗强直性髋关节炎的效果。方法选取2019年5月至2021年5月在我院拟实施THR的60例强直性髋关节炎患者为研究对象,将其随机分为观察组和对照组,每组30例。观察组采用直接前方入路,对照组采用后外侧入路。比较两组的治疗效果。结果术后3个月,观察组的疼痛、功能、活动、畸形评分及总分略高于对照组,但差异无统计学意义(P>0.05)。术后3个月,观察组的患肢外展、外旋角度大于对照组(P<0.05)。术后4周及术后3、6个月,观察组的视觉模拟评分法(VAS)评分、C反应蛋白(CRP)水平低于对照组,肌力评分高于对照组(P<0.05)。观察组的不良结局总发生率低于对照组(P<0.05)。结论强直性髋关节炎患者THR术中,采取直接前方入路可改善患肢活动度,减少不良结局的发生,值得推广。

Objective To investigate the effect of total hip replacement(THR)via direct anterior approach in the treatment of ankylosing arthritis of hip.Methods A total of 60 patients with ankylosing arthritis of hip who planned to undergo THR in our hospital from May 2019 to May 2021 were selected as the research objects and randomly divided into observation group and control group,with 30 cases in each group.The direct anterior approach was used in the observation group,while the posterior lateral approach was used in the control group.The treatment effects of the two groups were compared.Results At 3 months after operation,the scores of pain,function,activity,deformity and total score in the observation group were slightly higher than those in the control group,but the differences were not statistically significant(P>0.05).At 3 months after operation,the angle of abduction and external rotation of the affected limb in the observation group were greater than those in the control group(P<0.05).At 4 weeks,3 and 6 months after operation,the Visual Analogue Scale(VAS)score and C-reaction protein(CRP)level in the observation group were lower than those in the control group,and the muscle strength score was higher than that in the control group(P<0.05).The total incidence of adverse outcomes in the observation group was lower than that in the control group(P<0.05).Conclusion During THR in patients with ankylosing arthritis of hip,the direct anterior approach can improve the range of motion of the affected limb and reduce the occurrence of adverse outcomes,which is worthy of promotion.