前外侧入路与后外侧入路行全髋关节置换术的临床疗效比较

目的比较全髋关节置换术（THA）前外侧入路与后外侧入路的临床疗效。方法84例96髋随机分为两组，每组均为42例48髋，前外侧组（ASA组）行前外侧入路全髋关节置换术；后外侧组（PSA组）行后外侧入路全髋关节置换术；术后比较两组的手术时间、出血量、切口长度、术后住院时间、术后关节Harris评分及SF-36生活质量评分。结果ASA组手术切口长度、手术时间和术后住院时间分别为（13．16±0．92）cm、（64．07±9．32）min和（13．16±2．51）d，均显著低于PSA组（P〈0．05），两组手术失血量间比较差异无统计学意义（P〉0．05）；ASA组术后1年髋关节功能Harris评分达到（90．16±12．57）分，显著高于治疗前和PSA组术后Harris评分（P〈0．05），ASA组髋关节功能Harris评分及优良率达到64．58％，显著高于PSA组的54．17％（P〈0．05）；ASA组总体健康评分达到（73．08±5．26）分，显著高于PSA组的（69．26±5.31）分（P〈0．05）。结论选择前外侧入路行全髋关节置换术较后外侧入路切口小，手术时间短，术后恢复快，术后关节功能更好，患者生活质量更高，综合疗效优于PSA全髋关节置换术。

Clinical efficacy of total hip arthroplasty with anterolateral and posterolateral approach.

Objective To compare the clinical efficacy of total hip arthroplasty （THA） with anterolateral approach and posterolateral approach. Methods Eighty-four patients with 96 hips were selected and randomly divided into two groups, each with 42 cases of 48 hips. The anterolateral group （ASA group） carried out THA with anterolateral approach, while the posterior lateral group （PSA group） carded out THA with posterolateral approach. The operation time, amount of bleeding, the length of incision, postoperative hospitalization time, Harris score and SF-36 score of quality of life between the two groups were compared after replacement. Results The operation incision length, operation time and postoperative hospitalization time of the ASA group were （13.16±0.92） cm, （64.07±9.32） rain and （13.16±2.51） d, respectively, all significantly lower than those of the PSA group （P〈0.05）. The amount of operation bleeding between two groups had no significant difference （P〉0.05）. The Harris hip function score one year after operation in the ASA group was （90.16±12.57）, significantly higher than before treatment and the PSA group. The excellent and good rate in the ASA group was 64.58%, significantly higher than 54.17% in the PSA group （P〈0.05）. The overall health score of the ASA group was （73.08±5.26）, significantly higher than （69.26±5.31） in the PSA group （P〈0.05）. Conclusion Total hip arthroplasty by anterolateral approach has smaller incision operation, less bleeding, shorter operation time, faster postoperative recovery, better joint function after operation, compared with total hip arthroplasty by pos- terolateral approach. Besides, the quality of life of the patients is higher, and comprehensive curative effects are better.