改良髋臼前倾角及外展角校验系统在不同入路全髋关节置换术中的应用

Application of Modified Acetabular Anteversion and Abduction AngleCalibration System in Different Approaches of Total Hip Arthroplasty

目的 探讨改良髋臼前倾外展角校准系统在不同入路全髋关节置换手术(total hip arthroplasty, THA)中的应用效果。方法 选取2020年1月至2021年12月武汉中西医结合骨科医院骨关节科行初次单侧THA的64例股骨头坏死患者为研究对象。按照手术入路,将患者分为直接前入路组(direct anterior approach, DAA)31例,其中男18例,女13例;年龄57~75岁,平均年龄(61.8±7.2)岁;后路入路组(posterior approach, PA)33例,其中男20例,女13例;年龄58~74岁,平均年龄(63.4±8.3)岁。使用改良髋臼前倾外展角校准系统,评价术中和术后1周髋臼假体位置情况,术后1周和6个月评估Harris髋关节功能评分。记录患者术后再次骨折,脱位及下肢静脉血栓的发生率。结果 两组术中及术后髋臼外展角及前倾角的比较差异无统计学意义(P>0.05)。两组术后Harris评分比较差异无统计学意义(P>0.05)。两组患者术后并发症的发生率比较差异无统计学意义(P>0.05)。结论 采用改良髋臼前倾外展角校准系统对PA入路和DAA入路的THA手术疗效进行评价,二者手术疗效相当。

Objective To explore the effect of an improved acetabular anteversion abduction angle calibration system in total hip arthroplasty(THA)through different approaches.Methods We selected 64 patients with femoral head necrosis who underwent unilateral THA for the first time from January 2020 to December 2021 in the Osteoarthrology Department of Wuhan Integrated Traditional Chinese and Western Medicine Orthopedic Hospital as the research subjects.According to the surgical approach,patients were divided into a direct anterior approach(DAA)group(n=31),with 18 males and 13 females.The age ranged from 57~75 year,with an average of(61.8±7.2)years.Posterior approach(PA)group(n=33)had 20 males and 13 females.The age ranged from 58~74 year,with an average of(63.4±8.3)years.Using the improved acetabular anteversion abduction angle calibration system,we evaluated the acetabular prosthesis position during and 1 week after surgery,and evaluate the Harris hip joint function score at 1 week and 6 months after surgery.The incidence of recurrent fractures,dislocations and lower limb venous thrombosis was recorded.Results There was no statistically significant difference in the comparison of acetabular abduction angle and anteversion angle between the two groups during and after surgery(P>0.05).There was no statistically significant difference in Harris scores between the two groups after surgery(P>0.05).There was no statistically significant difference in the incidence of postoperative complications between the two groups of patients(P>0.05).Conclusion According to the modified acetabular anteversion abduction angle calibration system,the efficacy of THA surgery through PA and DAA approaches have comparable surgical outcomes.