直接前方入路与后外侧入路行人工全髋关节置换术对髋臼假体位置影响的比较研究  

Comparative study on differences in acetabular position during total hip arthroplasty between by direct anterior approach and by posterolateral approach

作　　者：刘宇[1] 桑伟林[1] 姜亚飞[1] 马金忠[1] 

机构地区：[1]上海交通大学附属第一人民医院骨科,上海200080

出　　处：《中国修复重建外科杂志》2017年第7期790-793,共4页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的比较直接前方入路与传统后外侧入路行人工全髋关节置换术后髋臼假体位置的差异。方法将2008年12月—2015年12月收治并符合选择标准的102例行人工全髋关节置换术患者纳入研究;置换术中采用直接前方入路51例(直接前方入路组)、后外侧入路51例(后外侧入路组)。两组患者性别、年龄、体质量指数、髋别、病因等一般资料比较,差异均无统计学意义(P>0.05),具有可比性。于术后第1天患者骨盆正位X线片测量髋臼外展角及前倾角,并根据以上两指标评价髋臼假体是否位于安全区域。结果直接前方入路组髋臼外展角和前倾角分别为(42.28±5.77)、(21.14±5.17)°,后外侧入路组分别为(43.93±7.44)、(21.05±4.10)°,比较差异均无统计学意义(t=1.30,P=0.19;t=0.05,P=0.96)。直接前方入路组髋臼外展角、前倾角位于安全区域比例分别为88.2%(45/51)、80.4%(41/51),后外侧入路组为84.3%(43/51)、82.4%(42/51),比较差异均无统计学意义(χ~2=0.33,P=0.56;χ~2=0.06,P=0.79)。直接前方入路组髋臼外展角及前倾角均在安全区域的比例为70.6%(36/51),后外侧入路组为68.6%(35/51),比较差异无统计学意义(χ~2=0.05,P=0.82)。结论采用直接前方入路或后外侧入路行人工全髋关节置换术,髋臼假体位置无明显差异。Objective To compare the differences in acetabular position during total hip arthroplasty （THA） between by direct anterior approach and by posterolateral approach. Methods Between December 2008 and December 2015, 102 patients undergoing THA were included in the study. THA was performed by anterior approach in 51 cases （anterior group） and by posterolateral approach in 51 cases （posterolateral group）. There was no significant difference in gender, age, body mass index, side, and cause of illness between 2 groups （P〉0.05）, with comparability. The acetabular abduction angle and anteversion angel were measured on the X-ray film at 1 day after operation to evaluate whether the acetabular prosthesis was displaced in the safe zone. Results The acetabular abduction angle was （42.28±5.77）° in the anterior group and was （43.93±7.44）° in the posterolateral group, showing no significant difference （t=1.30, P=0.19）. The acetabular anteversion angle was （21.14±5.17）° in the anterior group and was （21.05±4.10）° in the posterolateral group, showing no significant difference （t=0.05, P=0.96）. The ratio in the target safe zone of the acetabular abduction angle in the anterior group and the posterolateral group were 88.2% （45/51） and 84.3% （43/51） respectively, showing no significant difference （X^2=0.33, P=0.56）. The ratio in the target safe zone of the acetabular anteversion was 80.4% （41/51） in the anterior group and was 82.4% （42/51） in the posterolateral group, showing no significant difference between 2 groups （X2=0.06, P=0.79）. The ratio in the target safe zone of both the abduction and anteversion angel was 70.6% （36/51） in the anterior group and was 68.6% （35/51） in the posterolateral group, showing no significant difference （X^2=0.05, P=0.82）. Conclusion There is no differences in the acetabulum position during THA between by direct anterior approach and posterolateral approach.

关 键 词：人工全髋关节置换术 直接前方入路 后外侧入路 髋臼位置 

分 类 号：R687.4[医药卫生—骨科学]