后外侧入路小切口全髋关节置换术治疗晚期股骨头缺血性坏死  

Posterolateral Approach Mini-incision Total Hip Arthroplasty for Avascular Necrosis of the Femoral Head

作　　者：姜红江[1] 黄相杰[1] 周志高[1] 刘德忠[1] 王友强[1] 高广凌[1] 焦明航[1] 宋修刚[1] 王亮[1] 

机构地区：[1]山东省文登整骨医院,山东文登264400

出　　处：《中国中医骨伤科杂志》2008年第7期10-12,共3页Chinese Journal of Traditional Medical Traumatology & Orthopedics

摘　　要：目的:探讨后外侧入路小切口全髋置换术治疗晚期股骨头缺血性坏死的可行性和手术效果。方法:采用小切口全髋关节置换术治疗晚期股骨头缺血性坏死,临床应用60例68髋,其中男48例,女12例;体重指数17.0~24.5,平均20.2;年龄30~65岁,平均46.5岁;其中骨水泥型12髋,非骨水泥型43髋,混合型13髋;随访17~46个月,平均27.3个月。结果:所有患者均在术前设计切口下完成手术,切口长度7.5cm^10cm,平均(8.5±0.7)cm,单髋手术平均时间62min(50~80min),术中出血平均380ml(180~560ml)。术后假体位置良好,与周围骨组织结合良好。髋关节功Harris评分从术前平均42分(10~45分),提高到术后平均93.6分(68~97分)。结论:在术前准备充分、解剖入路熟悉的前提下,经后外侧入路小切口全髋关节置换术治疗股骨头缺血性坏死疗效确切,且具有创伤小、术后关节功能恢复快、瘢痕小,外形美观、减轻患者痛苦和经济负担等优点,是一种值得提倡的手术方法。Objective： To study the feasibility and efficacy of posterolateral approach mini--incision total hip arthroplasty （THA） for late avascular necrosis of the femoral head （ANFH）. Methods： Mini--incision THA was applied to 60 cases （68 hips） of late ANFH, with 48 males and 12 females, aging from 30 to 65 years,averagely 46.5 years. There were 12 hips with cement prosthesis, 43 with cementless prosthesis and 13 with mixed prosthesis. The follow--up time averaged 27.3 months, ranging from 17 to 46 months. Results： Mean skin incision length was （8.5±0.7）cm （ranging from 7.5cm to 10cm） ; Mean surgical time on single hip was 62 minutes （ranging from 50 minutes to 80 minutes） ; Mean blood loss was 380ml （ranging from 180ml to 560ml）. At short--term follow--up there was good position and incorporation of the im- plants with periprosthetic bone modeling. The mean Harris scores increased from preoperative 42 （10 to 45） to postoperative 93.6 （68-97）. Conclusion： Based on sufficient preoperative preparations and familiarity with anatomic approach, mini --incision THA has potential to reduce soft--tissue trauma, speed the postoperative recovery, improve cosmetic appearance of the scar and reduce pain and economic burden of patients, which is a recommendable procedure for ANFH.

关 键 词：全髋关节置换术 小切口 后外侧入路 股骨头坏死 临床效果 

分 类 号：R687.4[医药卫生—骨科学] R681.05[医药卫生—外科学]