前外侧微创全髋关节置换术的应用评价（附52例）

目的探讨前外侧肌间隙入路微创人工全髋关节置换术(THR)的临床疗效及优缺点。方法自2009年1月~2011年10月52例病人采用前外侧微创入路行THR,对本组患者在手术时间、出血量、切口长度、围手术期并发症、髋臼杯外展角、前倾角、术后Harris评分及影像学评价等方面进行回顾性分析。结果手术时间平均85分钟,术中平均出血量220ml。影像学评价51病例假体位置可,1例髋臼前倾角偏大,术后2天脱位后行翻修术。术后1、3、6月Harris评分平均85.1、87.2、90.8分。结论前外侧微创入路具有单一切口能完成髋臼和股骨假体安装,创伤少,真正肌间隙入路,术后早期功能恢复快等优点,但有一定的适应症,需要熟练的手术操作技术和较长的学习曲线。

Clinical application of minimally invasive anterolateral muscles sparing approach total hip arthroplasty: A report of 52 cases

Abstract] Objective To evaluate the clinic effect, advantages, and disadvantages of minimally invasive anterolateral muscles sparing approach Total Hip Arthroplasty. Methods From January 2009 to October 2011, 52 patients were recruited and were treated by total hip arthroplasty with anterolateral muscles sparing approach. Operation time, blood loss, incision length, complications, abduction angle of acetabular cup, anteversion angle of femoral prosthesis, post-operative Harris hip score, and imaging evaluation were evaluated. Result The average operative time was 85min, and average blood loss was 220ml. 51 cases showed good prosthesic position, while 1 case of revision because of dislocation two days after operation. Average Harris hip score at the first, third, and sixth months after operation were 85.1, 88.2, and 90.8, respectively. Conclusion By using minimal invasive anterolateral approach, acetabular and femeral stem are implanted in single small incision. It has the advantage of less trauma and real muscle sparing approach, and early post-operative function recovery can be achieved. However, this approach requires strict indication selection, skillful surgical technique and long term training .