改良Hardinge入路全髋置换在双下肢等长控制中的应用

目的评价改良Hardinge入路全髋置换在双下肢等长控制中的应用效果。方法对行改良Hardinge入路全髋置换及术中用自创等长测量方法进行双下肢等长控制并获1年以上随访的100例患者进行总结,采用Harris标准对髋关节功能进行评定。结果 100例患者均获随访,时间12~60(26±2.1)个月。Harris评分:优92例,良7例,可1例,优良率99%。下肢等长95例,下肢不等长在0.3~0.5 cm之间3例,相差0.6cm1例,相差0.8 cm 1例。结论该入路暴露好,假体安装定位好,因术中下肢基本处于标准侧卧位,易于控制下肢长度,特别适用自创的术中精确测量调控双下肢等长的手术方法,可减少因体位原因导致的误差,术后外展肌恢复快,总体恢复良好。

Application of improved Hardinge approach for total hip replacement in limb length control system

Objective To evaluate the application of improved Hardinge approach in total hip arthroplasty in limb length control system. Methods The improved Hardinge approach and length measurement methods were used for total hip arthroplasty. 100 cases were followed up for more than 1 year. The Harris standard was used to evaluate the hip joint function. Results All 100 cases were followed up for 12-60 （26 ± 2. 1） months. The results were excel-lent in 92 cases, good in 7, and fair in 1, the excellent-good rate was 99%. 95 cases got equalized legs, leg length discrepancy was between 0. 3-0. 5 cm in 3 cases, 0. 6 cm in 1 case and 0. 8 cm in 1. Conclusions This approach provides good exposure and good positioning of prosthesis. Lower limb length can be controlled in standard lateral po-sition, especially with our own long intraoperative surgical method to accurately measure the regulation of both lower extremities. Abductor can get faster recovery after surgery, which facilitate good recovery.