小切口前外侧入路在髋关节置换术中的应用

目的：探讨小切口经髋关节前外侧入路行人工髋关节置换术的可行性及治疗效果。方法：2007年3月-2009年11月,应用髋关节前外侧小切口关节囊前方入路完成人工髋关节置换12例（13髋）,记录手术时间、术中出血量、手术切口长度和术后引流量,随访所有患者的功能康复情况。结果：手术均在长度6.0-10 cm（平均8 cm）的小切口前外侧入路下完成,全髋关节置换手术时间40-100 min（平均70 min）,术中出血量280-400 mL（平均340 mL）,术后48h引流量120-340 mL（平均270 mL）;人工股骨头置换手术时间38-50 min（平均45 min）,术中出血量90-170 mL（平均130mL）,术后48 h引流量50-190 mL（平均120 mL）。所有患者随访6-12个月,平均9个月。术后8周可负重行走,功能康复满意。采用Harris评分标准评定疗效：优8例,良3例,中1例,优良率91.7%。结论：本组12例13髋用此术式具有创伤小、失血少、关节功能恢复快、术后脱位率低、手术期并发症少的特点。

The Application of Mini-incision Hip Replacement through Anterior-lateral Approach

Objective：To study the feasibility and therapeutic effect of mini-incision hip replacement through anterior-lateral approach.Methods：From March 2007 to November 2009,12 cases（13 hips） received mini-incision total hip replacement through anterior-lateral approach.The indexes of operation time,blood loss during the operation,the incision length,the drainage volume after surgery,and the functional rehabilitation of all patients were recorded.Results： All operations were performed under a length of 6.0 to 10cm（8cm on average） small incision via anterior-lateral approach.The average operation time for total hip replacement was 40 to 100 mins（70 mins on average）,blood loss was 280ml to 400ml（340ml on average）,and drainage amount in 48 hours after operation was 120ml to 340ml（270ml on average）.The average operation time for artificial femoral head replacement was 38 to 50mins（45mins averagely）,blood loss during operation was 90ml to 170ml（130ml averagely）,and drainage amount in 48 hours after operation was 50-190ml（120ml averagely）.A follow-up of 6 to 12 months（9months averagely） of all patients was made,which showed that all patients were able to walk with load 8 weeks after operation and obtained satisfactory functional rehabilitation.According to the evaluation of Harris grading system on efficacy,the effect was excellent in 8 cases,good in 3 cases and medium in 1 case,with an excellent and good rate 91.7%.Conclusion：The technique has the advantages of minimal trauma,little blood loss,fast recovery of joint function,low postoperative dislocation rate and fewer complications in operation period.