中国组织工程研究

中国组织工程研究 ›› 2012, Vol. 16 ›› Issue (9): 1538-1542.doi: 10.3969/j.issn.1673-8225.2012.09.005

• 人工假体 artificial prosthesis • 上一篇    下一篇

前外侧小切口与常规后外侧切口全髋关节置换的疗效对比★

黄晓文，程  力，何天达，刘  仪，王  烨，朱浩明   

  1. 南京医科大学附属无锡人民医院骨科，江苏省无锡市  214000
  • 出版日期:2012-02-26 发布日期:2012-02-26
  • 通讯作者: 程力，硕士，主任医师，教授，南京医科大学附属无锡人民医院骨科，江苏省无锡市 214000 chengli8831113@yahoo.com.cn
  • 作者简介:黄晓文★，男，1986年生，江苏省南京市人，汉族，在读硕士，主要从事脊柱外科方面的研究。 nanjinghuangxiaowen@yahoo.com.cn

Efficiency of minimally invasive total hip arthroplasty with anterolateral approach versus the traditional total hip arthroplasty with posterolateral approach

Huang Xiao-wen, Cheng Li, He Tian-da, Liu Yi, Wang Ye, Zhu Hao-ming   

  1. Department of Orthopedics, Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi  214000, Jiangsu Province, China
  • Online:2012-02-26 Published:2012-02-26
  • Contact: Cheng Li, Master, Chief physician, Professor, Department of Orthopedics, Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi 214000, Jiangsu Province, China chengli8831113@yahoo.com.cn
  • About author:Huang Xiao-wen★, Studying for master’s degree, Department of Orthopedics, Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi 214000, Jiangsu Province, China nanjinghuangxiaowen@yahoo.com.cn

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摘要：

背景：目前国内全髋关节置换以后外侧入路传统手术为主，损伤大，恢复慢，小切口手术未普及运用，前外侧小切口入路手术报道极少，临床RCT研究几乎空白。
目的：对比前外侧小切口与传统后路切口全髋关节置换的临床疗效。
方法：选择2008-06/2009-09在南京医科大学附属无锡人民医院行全髋关节置换的患者共102例，随机分实验组(n=55)和对照组(n=47)，分别采用前外侧小切口和传统后路切口方法进行全髋关节置换。
结果与结论：与对照组相比，实验组患者全髋关节置换的伤口小，手术时间短，术中出血少(P < 0.05)，置换后早期(2周，3个月)Harris评分高(P < 0.05)，但2组置换后髋臼外展角和不良事件发生率接近(P > 0.05)，且置换后6个月，1年时Harris评分差异无显著性意义(P > 0.05)。说明前外侧小切口全髋关节置换能在不影响临床疗效的前提下能够减轻手术创伤、缩短手术时间、减少出血、减轻置换后疼痛，置换后早期功能恢复快，是一种安全可靠有效的方法。
关键词：髋；置换；关节成形；康复；临床随访
doi:10.3969/j.issn.1673-8225.2012.09.005

关键词: 髋, 置换, 关节成形, 康复, 临床随访

Abstract:

BACKGROUND: Now, domestic total hip arthroplasty (THA) surgeries are mainly traditional THA with posterolateral approach which has larger damage and slower recovery. Minimally invasive surgery is not popularization utilization, studies on minimally invasive THA with anterolateral approach are rarely and clinical randomized controlled trial studies are almost blank.
OBJECTIVE: To compare the clinical effect of the minimally invasive THA with anterolateral approach and the traditional THA with posterolateral approach.
METHODS: Totally 102 patients who treated with THA from Affiliated Wuxi People’s Hospital of Nanjing Medical University from June 2008 to September 2009 were randomly divided into experimental group (n=55) and control group (n=47). The minimally invasive THA with anterolateral approach was used for the experimental group, and the traditional THA with posterolateral approach was used for the control group.
RESULTS AND CONCLUSION: Compared with the control group, incision length, operation time were shorter, hemorrhage amount was less (P < 0.05), Harris score was higher at postoperative early stage (2 weeks, 3 months) in the experimental group (P < 0.05). There was no difference in the abduction angle of acetabulum cup and complications between the two groups (P > 0.05). Harris score in the two groups had no significant difference at postoperative six weeks and one year (P > 0.05). It is indicated that the minimally invasive THA with anterolateral approach is a safe and effective technique with the advantages of less surgical trauma, shorter operation time, fewer blood loss, slighter pain and rapid recovery of function.

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