摘要
全髋关节置换术(THA)是治疗髋关节骨关节炎、股骨头坏死、股骨颈骨折、发育性髋关节发育不良等髋关节疾患的有效方法。随着精准外科及微创手术的发展,小切口全髋关节置换术及加速康复理念逐渐深入人心。微创意味更加准确的切口选择、更加精准的手术操作、更少的组织切开与牵拉损伤、更小的创伤打击、更安全的手术过程及更快速的功能康复。SuperPATH入路微创THA切口小,通过钝性分离臀小肌及梨状肌并从肌间隙进入。术中无需切断外旋肌群及韧带,术后当日即可完全负重进行患肢功能锻炼,明显缩短住院时间,实现早期加速康复,显著提高患者满意度。该技术近期疗效较好,但也存在术野暴露不良、假体定位不准确、学习曲线较长等不足,中远期疗效有待进一步研究。
Total hip arthroplasty is an effective treatment for hip osteoarthritis,femoral head necrosis, fracture of neck of femur, developmental dysplasia of hip and other hip diseases. With the development of precision surgery and minimally invasive technology, the concept of THA with small incision and enhanced recovery after surgery has gradually became more and more popular. Minimally invasive technique has more accurate selection, more accurate operation incision, less tissue slice and traction injury, less trauma, safer operation process and more rapid recovery of functions. SuperPATH approach in total hip arthroplasty has small incision, entering from the muscle gap through a blunt separation of the gluteus minimus and the piriformis muscle without cutting off abductors and ligaments, which can shorten the length of hospital stay, achieve enhanced recovery after surgery and significantly improve the patient’s satisfaction for the patients are able to carry out a full weight-bearing exercise on the day the operation completed. Relevant research shows that the technique has a good short-term effect, however,there are also some shortcomings such as poor exposure, long learning curve and inaccurate positioning of prosthesis. Thus, the mid-or long-term effect needs to be further observed and studied.
作者
孙茂淋
何锐
张颖
郭林
陈光兴
杨柳
SUN Maolin;HE Rui;ZHANG Ying;GUO Lin;CHEN Guangxing;YANG Liu(Center for Joint Surgery,First Affiliated Hospital,Army Medical University,Chongqing 400038,China)
出处
《中华骨与关节外科杂志》
2019年第4期316-320,共5页
Chinese Journal of Bone and Joint Surgery
关键词
SuperPATH入路
全髋关节置换术
加速康复
微创
SuperPATH Approach
Total Hip Arthroplasty
Enhanced Recovery After Surgery
Minimally Invasive
