摘要
目的探讨下肢牵引架辅助下前侧微创入路全髋关节置换术（THA）治疗髋部疾病的近期疗效。方法回顾性分析2013年8月至2015年8月期间收治的115例（138髋）髋部疾病患者资料。男71例，女44例；年龄为28～77岁，平均59．4岁；体质量指数为19．7～28．9kg／m2，平均24．7kg／m!；髋关节疾病类型：股骨头缺血性坏死56例，病程平均为15．7个月；骨性关节炎35例，病程平均为12．6个月；髋关节发育不良14例，病程平均为2．8年；炎性反应性关节炎10例，病程平均为6．8年。所有患抒均采用下肢牵引架辅助下前侧微创入路初次THA治疗。结果115例（138髋）患者术后获平均31．6个月（12～40个月）随访。本组患者的切口长度平均为9．4cm，手术时间平均为115．9min，术中出血量甲均为210．2mL，住院时间平均为7．5d。术后影像学评价结果：髋臼外展角平均为41．6°（37°～56°），髋刚丽倾角平均为18．1°（11°～23°）。术后1年115例（138髋）患者髋关节Harris评分平均为91．4分（80～96分）。1例1髋（O．7％）患者术中发生股骨近端劈裂骨折，6例7髋（5．1％）患者术后出现股外侧皮神经损伤症状。随访期间无一例患者发生深部感染、髋关节脱位、深静脉血栓形成及假体松动等并发症。结论下肢牵0I架辅助下前侧做创入路THA近期疗效良好，术后患者髋关节功能得到快速康复，患者术中及术后并发痱明显减少。
Objective To evaluate the short-term clinical results of total hip arthroplasty （THA） through a direct anterior minimally invasive approach aided by lower extremity tractor tor hip diseases. Methods Between August 2013 and August 2015, 115 patients （138 hips） were admitted for hip diseases. They were 71 men and 44 women, aged from 28 to 77 years （average, 59.4 years） . Their body mass indexes ranged from 19.7 kg/m2 to 28.9 kg/m2, averaging 24.7 kg/m2. Their hip diseases included avascular necrosis of the femoral }lead in 56 cases （with an average disease course of 15.7 months）, hip osteoarthritis in 35 cases （with an average disease course of 12.6 mouths）, hip dysplasia in 14 cases （with an average disease course of 2.8 years） and inflanuuatory artllritis in l0 cases （with an average disease course of 6.8 years）. All the patients were treated by primary THA through a direct anterior mininmlly invasive approach and assistance of lower ex- tremity tractor. Results All the 115 patients （138 hips） were followed up for an average of 31.6 months （tYom 12 to 40 mouths） . Their average length of iucision was 9.4 cm, average operative time 115.9 rain, av- erage blood loss 210.2 mL, and average hospital stay 7.5 days. Their postoperative imaging results were as follows： the angles of acetabular abduction averaged 41.6% （from 37% to 56%） and the angles of acetabular an- reversion 18. 1 % （from 11% to 23%）. Their average Harris hip score one year postoperatively was 91.4 points （from 80 to 96 points）. Split fracture of the proximal fenmr happened in one patient （one hip） （0.7%） intraopera- tively; injury to lateral femoral cutaneous never was observed in 6 patients （7 hips） （5. 1% ）. Complications like deep infection, hip dislocation, deep vein thrombosis or prosthetic loosening were not observed during fol- low-ups. Conclusions THA with assistance of lower extremity tractor through a direct anterior minimally invasive approach can lead to fine short-term clin
出处
《中华创伤骨科杂志》
CAS
CSCD
北大核心
2017年第5期450-453,共4页
Chinese Journal of Orthopaedic Trauma
基金
江西省卫生计生委科技计划项目（20175369,20175391）
赣州市科技计划项目（GZ2016ZSF002）
关键词
关节成形术
置换
髋
股骨头坏死
骨关节炎
手术入路
外科手术
微创性
Arthroplasty, replacement, hip
Fenlur head necrosis
Osteoarthritis
Surgicalapproach
Surgical procedures, minimally invasive
