SuperPATH入路髋关节置换术治疗股骨颈骨折的临床疗效

Clinical effect of SuperPATH approach in total hip arthroplasty for femoral neck fractures

目的探讨SuperPATH入路髋关节置换术治疗股骨颈骨折患者的临床疗效。方法采用回顾性病例对照研究。选取2019年1月~2023年10月在空军军医大学第一附属医院骨科行全髋关节置换术(total hip arthroplasty,THA)的股骨颈骨折患者120例,按照手术方法分为研究组(n=61例)和对照组(n=59例)。研究组采用SuperPATH入路,对照组采用后外侧入路。比较两组围术期相关指标,术后3 d、术后2周及术后1个月时的疼痛视觉模拟评分(visual analog scale,VAS)、髋关节功能Harris评分,术后1个月时的髋关节活动度,以及并发症发生率。结果围术期相关指标比较,两组手术时间、术中出血量比较均无统计学意义(P>0.05),但研究组切口长度更短,术后下床活动时间及术后住院时间均短于对照组(P<0.05)。研究组术后3 d时的VAS低于对照组(P<0.05);术后3 d、术后2周时的Harris评分高于对照组(P<0.05);其他时点两组比较无统计学差异(P>0.05)。术后1个月时,研究组髋关节屈曲、外旋、内旋、外展、内收活动度明显大于对照组(P<0.05)。研究组并发症发生率为4.92%,数值上低于对照组的11.86%,但两组比较无统计学差异(P>0.05)。结论SuperPATH入路髋关节置换术治疗股骨颈骨折,可改善围手术期各项指标,有效减轻术后疼痛,提高髋关节功能,改善髋关节活动度,值得临床推广应用。

Objective To explore the clinical efficacy of SuperPATH approach in total hip arthroplasty(THA)for patients with femoral neck fractures.Methods A retrospective case-control study was used.120 patients with femoral neck fractures who underwent THA in the Orthopedics Department of the First Affiliated Hospital of Air Force Medical University from January 2019 to October 2023 were selected and divided into a study group(n=61)and a control group(n=59)according to the surgical methods.The research group used SuperPATH approach,while the control group used posterior lateral approach.It was compared of the perioperative related indicators,including pain visual analog scale(VAS),Harris hip score at 3 days,2 weeks and one month after operation,hip joint ranges of motion at one month after surgery,and incidence of complications between two groups.Results There was no significant difference in the comparison of operation time and intraoperative blood loss(P>0.05).However,the research group had a shorter incision length,shorter off-bed duration,and shorter postoperative hospitalization time compared to the control group(P<0.05).The VAS of the research group was lower than that of the control group at 3 days after surgery(P<0.05).The Harris scores at 3 days and 2 weeks after surgery were higher than that in the control group(P<0.05).At one month after operation,the hip joint flexion,external rotation,internal rotation,abduction,and adduction range of motion in the research group was significantly greater than that in the control group(P<0.05).The incidence of complications in the study group was 4.92%,which was lower than 11.86%in the control group in value,but there was no significant difference between the two groups(P>0.05).Conclusion The Super-PATH approach for THA in the treatment of femoral neck fractures can improve various perioperative indicators in the treatment of femoral neck fractures.It can effectively reduce postoperative pain,improve hip joint function,and improve hip joint mobility.It is worthy of clinical promotion and application.