两种髋关节入路的THA术后髋关节本体感觉的分析  

Analysis of Position Sense in THA Patient of Different Surgical Approaches

作　　者：张静宇[1] 

机构地区：[1]哈尔滨医科大学附属第一医院骨科,黑龙江哈尔滨150000

出　　处：《实用骨科杂志》2018年第1期35-38,共4页Journal of Practical Orthopaedics

摘　　要：目的关节的不稳定大致可分为机械性不稳和功能性不稳。据报道全髋关节置换术后脱位常发生在后侧入路,可能是由于关节周围软组织损伤引起的功能性不稳所致。因此我们对比了采用不同入路进行髋关节置换手术患者的髋关节位置觉,用以了解不同手术入路是否对术后脱位产生影响。方法 58例(116个髋关节)于我院接受髋关节置换的患者纳入研究,健康的没有影像学改变的对侧髋关节作为对照组。男性10例,女性48例;年龄40~84岁,平均年龄63.1岁。后外侧入路39个髋关节,前外侧入路30个髋关节,对照组是37个髋关节。结果前外侧入路(anterolateral approach,AL)组中的主动外旋的绝对复位角度误差明显低于后外侧入路(posterolateral approach,PL)组中的绝对复位角度误差,在AL组和对照组中被动内旋、外旋和主动内旋的相对复位角度误差明显低于PL组。结论在前外侧入路置换中由于关节周围软组织的保留,髋关节具有更好的位置觉。Objective Joint instability can be roughly divided into mechanical instability and functional instability.It is reported that postoperative dislocation often occurs in the posterior approach,may be due to injury of soft tissue around the joints,that caused functional instability.We analyzed the location sense of hip joints with different approaches for total hip arthroplasty and analyzed their effects on postoperative dislocation.Methods Fifty-eighty patients（116 hips）,who received THA in our hospital were admitted to our study.Patients with inadequate sensory measurements were excluded.The posterior approach involved 39 hip.There were 30 hip underwent anterolateral approach procedure,and 37 hip in the control group.Results The absolute reduction angle error of the active external rotation in the Al group is significantly lower than that in the PL group.In the AL group and the control group,the relative reduction angle of the passive internal rotation,external rotation and active internal rotation was significantly lower than that of the PL group.Conclusion This study shows that the patient has a better hip position sense in the anterolateral approach group due to the retention of soft tissue around the joint.

关 键 词：全髋关节置换 脱位 位置觉 

分 类 号：R687.42[医药卫生—骨科学]