中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (26): 4848-4851.doi: 10.3969/j.issn.1673-8225.2010.26.024

• 骨科植入物 orthopedic implant • 上一篇    下一篇

微创全髋关节置换与常规全髋关节置换比较：30例经验的提示

陈  凯，梁文清，李  健，蔡郑东，华莹奇，郑龙坡   

  1. 解放军第二军医大学第一附属医院骨科，上海市    200433
  • 出版日期:2010-06-25 发布日期:2010-06-25
  • 通讯作者: 蔡郑东，硕士，主任医师，教授，博士生导师，解放军第二军医大学第一附属医院骨科，上海市 200433
  • 作者简介:陈 凯，男，1983年生，江苏省启东市人，2008年解放军第二军医大学毕业，硕士，医师，主要从事骨关节、骨肿瘤等方面的研究。 ch_kai@163.com

Minimally invasive total hip arthroplasty versus standard total hip arthroplasty in 30 cases

Chen Kai, Liang Wen-qing, Li Jian, Cai Zheng-dong, Hua Ying-qi, Zheng Long-po   

  1. Department of Orthopaedic Surgery, First Affiliated Hospital of Second Military Medical University, Shanghai  200 433, China
  • Online:2010-06-25 Published:2010-06-25
  • Contact: Cai Zheng-dong, Master, Chief physician, Professor, Doctoral supervisor, Department of Orthopaedic Surgery, First Affiliated Hospital of Second Military Medical University, Shanghai 200 433, China
  • About author:Chen Kai, Master, Physician, Department of Orthopaedic Surgery, First Affiliated Hospital of Second Military Medical University, Shanghai 200 433, China ch_kai@163.com

PDF

331

摘要：

背景：国内已有部分医院采用微创进行髋关节置换，但切口大小报道不一，位置也不尽相同。
目的：比较微创全髋关节置换与常规全髋关节置换的置换指标及短期临床随访结果。
方法：对30 例30髋进行微创全髋关节置换，同期30例30髋采用常规后外侧入路行全髋关节置换，两组患者年龄、性别及体质量指数均衡(P > 0.05)，疾病谱相似。两组病例均采用施乐辉公司生产的非骨水泥型假体，比较两组病例的术中出血量、置换时间、切口长度、置换后早中期的功能锻炼情况及影像学评价结果。
结果与结论：微创组与常规组的切口长度、术中出血量、引流量及输血量的差异有显著性意义(P < 0.05)，微创组均优于常规组；两组患者置换时间、置换后影像学评价及髋臼角测量差异均无显著性意义(P > 0.05)。微创全髋关节置换组置换后早期功能恢复较常规全髋关节置换组快，而中期结果相似。置换后及随访时两组假体位置均良好。微创全髋关节置换组除有2例患者术中发生切口近端皮肤擦伤。提示微创全髋关节置换创伤小，围手术期出血少，切口小且不影响假体位置及置换后早期功能锻炼，可选择性用于部分病例的人工全髋关节置换。但应严格选择置换适应证，由拥有相应设备条件的医院及有一定经验的医生开展。

关键词: 关节成形术, 置换, 髋, 微创, 随访

Abstract:

BACKGROUND: Minimally invasive hip replacement has been utilized in some hospitals. However, the incision size and location are different.
OBJECTIVE: To compare the surgical experience and clinical outcome between minimally invasive total hip arthroplasty (THA) and conventional THA.
METHODS: A total of 30 cases (30 hips) underwent THA through a minimal incision posterolateral surgical approach (MIS group) and another 30 cases received THA through a standard posterolateral approach at the same period (standard group). The age, gender and body mass index between two groups were similar (P > 0.05), and their disease spectrum was similar. They were treated by cementless prosthesis (Smith &Nephew Company). The operation time, blood loss, incision length, functional recovery, and prosthetic position were analyzed and compared between the two groups.
RESULTS AND CONCLUSION: There were significant differences in average incision length, amount of bleeding, postoperative drainage and transfusion between two groups (P < 0.05), and the MIS group was superior to the standard group. There were no significant differences in operation time, postoperative imaging evaluation and acetabular angle between two groups (P > 0.05). Functional recovery of MIS group was rapid than standard group at the early stage, but the functions of joint were similar in middle-stage in both groups. Follow-up period after operation, the prosthesis position was good both in MIS and standard groups. There was no complication in MIS group with the exception of skin abrasin in two cases. The advantages of MIS THA are less traumatic blood loss, good cosmetic incision and rapid recovery of function. The MIS THA can only be used by surgeons rich in experience in THA and in hospitals provided with necessary instruments.

中图分类号: