Background It is well accepted that the minimally invasive surgery （MIS） for total hip arthroplasty （THA） should combine with less or no muscle damage and is different from mini-incision technique and MIS should h...Background It is well accepted that the minimally invasive surgery （MIS） for total hip arthroplasty （THA） should combine with less or no muscle damage and is different from mini-incision technique and MIS should have better outcomes than mini-incision surgery. The aim of current analysis was to apply an explicitly defined sub-group analysis to confirm whether this hypothesis is true. Methods A computerized literature search was applied to find any data concerning MIS or mini-incision THAs. A multistage screening was then performed to identify randomized studies fulfilling the inclusive criteria for the analysis. The data were extracted, and sub-group analyses of MIS or mini-incision surgery for different kinds of outcomes were carried out. The P（sub） value for difference between MIS sub-group and mini-incision sub-group was also calculated. Results Eleven studies that fulfilling the inclusion criteria were included, with 472 cases in the study group （MIS or mini-incision） and 492 cases in the conventional group. The overall analysis showed the study group would achieve less surgical duration （P=0.037）, intraoperative blood （P 〈0.001） and incision length （P 〈0.001） than conventional group. The difference between sub-groups showed, the MIS would achieve shorter incision length （P（sub） 〈0.05） and bigger cup abduction angle （P（sub） 〈0.05）, and cause more blood loss （P （sub） 〈0.05） than mini-incision technique. Other indexes were comparable between the two sub-groups. Conclusions Though further high quality studies are still needed, the result of current analysis offered an initial conclusion that MIS THA failed to achieve a better clinical outcome than mini-incision technique. The exact definition of MIS still needs to be improved.展开更多
目的探讨微创小切口人工全髋关节置换术对于晚期股骨头坏死患者的治疗效果。方法 84例晚期股骨头坏死患者,随机分为对照组与观察组,每组42例。对照组采用传统人工全髋关节置换术,观察组采用微创小切口人工全髋关节置换术。比较两组患者...目的探讨微创小切口人工全髋关节置换术对于晚期股骨头坏死患者的治疗效果。方法 84例晚期股骨头坏死患者,随机分为对照组与观察组,每组42例。对照组采用传统人工全髋关节置换术,观察组采用微创小切口人工全髋关节置换术。比较两组患者的手术疗效、各项手术指标、并发症发生情况。结果观察组髋关节功能优良率为90.48%,明显高于对照组的73.81%,差异具有统计学意义(P<0.05)。观察组手术时间、切口长度、术中出血量、住院时间均明显优于对照组,差异均具有统计学意义(P<0.05)。观察组与对照组并发症发生率(0 VS 2.38%)比较差异无统计学意义(P>0.05)。结论微创小切口人工全髋关节置换术对晚期股骨头坏死患者有良好的治疗效果,术后早期功能恢复快,髋关节功能恢复佳,且并发症发生率低,具有积极的临床意义。展开更多
目的比较采用Bikini切口直接前入路和前外侧入路行初次人工全髋关节置换术(total hip arthroplasty,THA)的近期疗效差异。方法将2015年6月—2016年3月收治并符合选择标准的60例股骨头缺血性坏死患者纳入研究。根据手术入路不同分为两组...目的比较采用Bikini切口直接前入路和前外侧入路行初次人工全髋关节置换术(total hip arthroplasty,THA)的近期疗效差异。方法将2015年6月—2016年3月收治并符合选择标准的60例股骨头缺血性坏死患者纳入研究。根据手术入路不同分为两组,30例行Bikini切口直接前入路THA(A组),30例行前外侧入路THA(B组)。两组患者性别、年龄、体质量指数、患髋侧别、股骨头缺血性坏死Steinberg分期以及术前血红蛋白、Harris评分、疼痛视觉模拟评分(VAS)比较,差异均无统计学意义(P>0.05),具有可比性。记录并比较两组患者手术时间、切口长度、术中出血量、输血率、开始直腿抬高功能锻炼时间、开始髋关节主动外展时间、住院时间、双下肢不等长发生率,以及髋关节Harris评分、VAS评分;复查骨盆正位X线片,测量髋臼杯外展角和前倾角。结果两组患者术后切口均Ⅰ期愈合,A、B组并发症发生率比较,差异无统计学意义(χ~2=0.144,P=0.704)。两组患者术后均获随访,随访时间3~12个月,平均6个月。两组手术时间、切口长度、术中出血量、输血率、住院时间及开始直腿抬高功能锻炼时间比较,差异均无统计学意义(P>0.05)。A组开始髋关节主动外展时间显著短于B组(t=–4.591,P=0.000),双下肢不等长发生率显著低于B组(χ~2=5.455,P=0.020)。两组术后2周、6周、3个月、6个月Harris评分以及术后24 h、6周VAS评分比较,差异均无统计学意义(P>0.05)。骨盆正位X线片复查示,术后2 d A、B组髋臼外展角、前倾角比较差异均无统计学意义(t=0.887,P=0.379;t=0.652,P=0.517);所有假体位置良好,无股骨假体下沉、髋臼杯移位或关节脱位等情况发生。结论采用两种手术入路进行微创THA均能避免肌肉损伤,并取得良好近期疗效。但与前外侧入路相比,Bikini切口直接前入路在术后患者开始髋关节主动外展时间和双下肢不等长发生率方面具有一定优势。展开更多
文摘Background It is well accepted that the minimally invasive surgery （MIS） for total hip arthroplasty （THA） should combine with less or no muscle damage and is different from mini-incision technique and MIS should have better outcomes than mini-incision surgery. The aim of current analysis was to apply an explicitly defined sub-group analysis to confirm whether this hypothesis is true. Methods A computerized literature search was applied to find any data concerning MIS or mini-incision THAs. A multistage screening was then performed to identify randomized studies fulfilling the inclusive criteria for the analysis. The data were extracted, and sub-group analyses of MIS or mini-incision surgery for different kinds of outcomes were carried out. The P（sub） value for difference between MIS sub-group and mini-incision sub-group was also calculated. Results Eleven studies that fulfilling the inclusion criteria were included, with 472 cases in the study group （MIS or mini-incision） and 492 cases in the conventional group. The overall analysis showed the study group would achieve less surgical duration （P=0.037）, intraoperative blood （P 〈0.001） and incision length （P 〈0.001） than conventional group. The difference between sub-groups showed, the MIS would achieve shorter incision length （P（sub） 〈0.05） and bigger cup abduction angle （P（sub） 〈0.05）, and cause more blood loss （P （sub） 〈0.05） than mini-incision technique. Other indexes were comparable between the two sub-groups. Conclusions Though further high quality studies are still needed, the result of current analysis offered an initial conclusion that MIS THA failed to achieve a better clinical outcome than mini-incision technique. The exact definition of MIS still needs to be improved.
文摘目的探讨微创小切口人工全髋关节置换术对于晚期股骨头坏死患者的治疗效果。方法 84例晚期股骨头坏死患者,随机分为对照组与观察组,每组42例。对照组采用传统人工全髋关节置换术,观察组采用微创小切口人工全髋关节置换术。比较两组患者的手术疗效、各项手术指标、并发症发生情况。结果观察组髋关节功能优良率为90.48%,明显高于对照组的73.81%,差异具有统计学意义(P<0.05)。观察组手术时间、切口长度、术中出血量、住院时间均明显优于对照组,差异均具有统计学意义(P<0.05)。观察组与对照组并发症发生率(0 VS 2.38%)比较差异无统计学意义(P>0.05)。结论微创小切口人工全髋关节置换术对晚期股骨头坏死患者有良好的治疗效果,术后早期功能恢复快,髋关节功能恢复佳,且并发症发生率低,具有积极的临床意义。
文摘目的比较采用Bikini切口直接前入路和前外侧入路行初次人工全髋关节置换术(total hip arthroplasty,THA)的近期疗效差异。方法将2015年6月—2016年3月收治并符合选择标准的60例股骨头缺血性坏死患者纳入研究。根据手术入路不同分为两组,30例行Bikini切口直接前入路THA(A组),30例行前外侧入路THA(B组)。两组患者性别、年龄、体质量指数、患髋侧别、股骨头缺血性坏死Steinberg分期以及术前血红蛋白、Harris评分、疼痛视觉模拟评分(VAS)比较,差异均无统计学意义(P>0.05),具有可比性。记录并比较两组患者手术时间、切口长度、术中出血量、输血率、开始直腿抬高功能锻炼时间、开始髋关节主动外展时间、住院时间、双下肢不等长发生率,以及髋关节Harris评分、VAS评分;复查骨盆正位X线片,测量髋臼杯外展角和前倾角。结果两组患者术后切口均Ⅰ期愈合,A、B组并发症发生率比较,差异无统计学意义(χ~2=0.144,P=0.704)。两组患者术后均获随访,随访时间3~12个月,平均6个月。两组手术时间、切口长度、术中出血量、输血率、住院时间及开始直腿抬高功能锻炼时间比较,差异均无统计学意义(P>0.05)。A组开始髋关节主动外展时间显著短于B组(t=–4.591,P=0.000),双下肢不等长发生率显著低于B组(χ~2=5.455,P=0.020)。两组术后2周、6周、3个月、6个月Harris评分以及术后24 h、6周VAS评分比较,差异均无统计学意义(P>0.05)。骨盆正位X线片复查示,术后2 d A、B组髋臼外展角、前倾角比较差异均无统计学意义(t=0.887,P=0.379;t=0.652,P=0.517);所有假体位置良好,无股骨假体下沉、髋臼杯移位或关节脱位等情况发生。结论采用两种手术入路进行微创THA均能避免肌肉损伤,并取得良好近期疗效。但与前外侧入路相比,Bikini切口直接前入路在术后患者开始髋关节主动外展时间和双下肢不等长发生率方面具有一定优势。
