全髋关节置换术的两种入路方式在髋关节疾病患者中的应用

目的对比分析全髋关节置换术中改良Hardinge入路和改良Watson-Jones入路在髋关节疾病患者中的疗效。方法选取75例我院收治的需行全髋关节置换术的髋关节疾病患者，随机分为H组（38例）和w组（37例），分别经改良Hardinge入路和改良Watson—Jones入路。详细记录患者的手术时间、Harris髋关节功能评分、Barthel指数和并发症发生情况等。结果H组患者的手术时间、下床时间和切口长度均较短，且术中出血量少于W组患者，差异有统计学意义（P〈0．05）。两组患者术后Harris评分和Barthel指数均获得明显提高（P〈0．05），术后3个月w组的Harris评分和Barthel指数均显著优于H组（P〈0．05），但末次随访时两组比较差异均无统计学意义（P〉0．05）。两组术后均无出现伤口感染、血管神经损伤、深静脉血栓或髋关节脱位等并发症。结论改良Hardinge入路和改良Watson-Jones入路均在全髋关节置换术中取得满意效果，其中改良Watson-Jones入路更安全有效。

Comparison of two approachs of total hip arthroplastyin in the treatment of hip joint disease.

Objective To compare the Modified Hardinge approach and Modified Watson-Jones approach of total hip arthroplasty in the treatment of the hip joint disease. Methods 75 patients with hip joint disease were selected and randomly divided into H group treated by the Modified Hardinge approach （n=38 cases） and W group treated by Modified Watson-Jones approach （n=37 cases）, respectively. Operation time, Harris hip score, Barthel index and complications were recorded. Results Theoperation time, bedactivity time and incision length in W group were shorter than those in H group, and its intraoperative blood loss was less than that in H group, with significant difference （P〈 0.05）. Two groups of patients with postoperative Harris score and Barthel index increased significantly （P〈0.05）, the Harris score and Barthel index of W group were significantly better than that of H group 3 months after surgery （P〈 0.05）, but there was no significant difference between the two groups at the time of the last follow-up Two groups have no wound infection, vascular and neural lesions, deep vein thrombosis or hip dislocation. Conclusion The Modified Hardinge approach and Modified Watson-Jones approach are satisfactory effect in the total hip arthroplasty, and the Modified Watson-Jones approach is more safe and effective.