改良直接外侧入路在初次全髋关节置换术中的应用

目的评价改良直接外侧入路在全髋关节置换术中的应用价值。方法自2004年4月～2005年6月，采用改良直接外侧入路行初次全髋关节置换术共84例86髋，以2003年4月～2004年4月后外侧入路行全髋关节置换术89例89髋为对照组，观察项目包括手术时间、术中失血量、Harris评分、术后脱位发生率、术后跛行情况。结果术后平均随访17．5个月，两组间手术时间、术中失血量、Harris评分优良率、术后脱位发生率、术后中重度跛行发生率差别均无统计学意义。结论改良直接外侧进路有助于提高全髋关节的稳定性，帮助患者尽快恢复日常生活，但相比后外侧入路尚无绝对的优势。

A Modified Direct Lateral Approach for Primary Total Hip Arthroplasty

Objective To evaluate the value of a modified direct lateral approach in the primary total hip arthroplasty.Methods Eighty-six hips in 84 patients undergoing the primary total hip arthroplasty with a modified direct lateral approach and 89 hips in 89 patients with the posterolateral approach were reviewed.The operative time,the blood loss,the Harris score,the postoperative dislocation and limp were recorded.Results The average period of follow-up was 17.5 months.There were no statistically significant difference in the operative time,the blood loss,the excellent and good rate of Harris score,the postoperative dislocation rate and the moderate and severe rate of limp between the two groups.Conclusion With the modified direct lateral approach,dislocation after primary total hip arthroplasty can almost be eliminated and a faster return to daily function can be achieved.However,this approach has no superiority over the posterolateral approach.