改良DAA全髋关节置换的临床应用  

Clinical application of modified direct anterior approach for total hip arthroplasty

作　　者：谢卫宁[1] 李华[1] 庞家省 甘六央 周烈超 唐家鹏[1] 庞科 马鹏[1] XIE Wei-ning;LI Hua;PANGJia-sheng;GAN Liu-yang;ZHOU Lie-chao;TANG Jia-peng;PANG Ke;MA Peng(Department of Osteopathy, YulinOrthopaedic Hospital of Integrated TCM & Western Medicine, Yulin 537000, Guangxi, CHINA)

机构地区：[1]玉林市中西医结合骨科医院骨病科,广西玉林537000

出　　处：《海南医学》2019年第10期1292-1296,共5页Hainan Medical Journal

基　　金：广西玉林市科学技术局科技攻关项目(编号:玉市攻20173051)

摘　　要：目的评价改良直接前方入路(DAA)全髋关节置换的临床疗效。方法对2017年1月至2018年9月玉林市中西医结合骨科医院骨病科由同一术者完成的应用改良DAA进行初次全髋关节置换术的52例(73髋)患者资料进行随访研究,随访3个月以上,使用Harris髋关节评分量表以及双下肢全长正位片进行临床和影像学方面评价临床效果。结果本组52例(73髋)获得随访,随访率为100%,随访时间3～20个月,中位随访6个月;术后X线片测量下肢等长;术前Harris评分为(49±7.1),术后末次随访髋关节功能Harris评分为(94±3.9),同术前相比,Harris评分显著改善,差异有统计学意义(P<0.05);末次随访时均无感染、脱位、松动等失败病例。结论改良DAA全髋关节置换对治疗终末期髋关节疾病具有较好的临床疗效,并发症少,是实现快速康复的一种微创入路,值得临床推广应用。Objective To evaluate the clinical efficacy of modified direct anterior approach(DAA) for total hip arthroplasty(THA). Methods A follow-up study was conducted on 52 patients(73 hips) who underwent primary THA with modified DAA completed by the same surgeon from January 2017 to September 2018 in the Department of Osteopathy at Yulin Orthopaedic Hospital of Integrated TCM & Western Medicine. Patients were followed up for more than 3 months. Clinical and radiographic outcomes were evaluated using the Harris Hip Score and full-length positive radiographs of both lower extremities. Results All the 52 patients(73 hips) were followed up, the follow-up rate was100%. The median follow-up duration was 6 months(range, 3 to 20 months). After operation, lengths of the lower limbs were equal on X-ray. The preoperative Harris score was(49±7.1) points, and the Harris score at the last follow-up was(94±3.9) points;the postoperative Harris score was significantly improved compared with the preoperative score(P<0.05). At the last follow-up, no infection, dislocation, loosening or other failed cases were found. Conclusion Modified direct anterior approach for total hip arthroplasty has better clinical efficacy in the treatment of end-stage hip disease, with fewer complications, and is a minimally invasive approach to achieve rapid recovery. It is worthy of clinical application.

关 键 词：改良 直接前方入路 全髋关节置换 松解 疗效 

分 类 号：R687.4[医药卫生—骨科学]