两种入路全髋关节置换术的早期结果比较  

Comparison of early outcomes of two approaches for total hip arthroplasty

作　　者：甘锋平 杨克勤[2] 林鑫欣[2] 谢兆林 张其标[2] 曾意荣 GAN Feng-ping;YANG Ke-qin;LIN Xin-xin;XIE Zhao-lin;ZHANG Qi-biao;ZENG Yi-rong(Guangzhou University of Traditional Chinese Medicine,Guangzhou 510405,China;Department of Orthopedics,Guigang People's Hospital,Guigang 537100,China;Department of Orthopedics,The First Affiliated Hospital,Guangzhou University of Chinese Medicine,Guangzhou 510405,China)

机构地区：[1]广州中医药大学,广东广州510405 [2]广西贵港市人民医院骨科,广西贵港537100 [3]广州中医药大学第一附属医院骨科,广东广州510405

出　　处：《中国矫形外科杂志》2022年第15期1414-1417,共4页Orthopedic Journal of China

摘　　要：[目的]比较SuperPATH与后外侧入路(posterolateral approach, PLA)初次全髋关节置换术(total hip arthroplasty,THA)的早期疗效。[方法] 2018年7月—2020年12月,对88例患者行THA。其中,45例采用SuperPATH入路,其中2例术中改为后外侧入路,43例纳入研究,43例采用PLA入路。比较两组围手术期、随访和影像资料。[结果]SuperPATH组切口长度、术后引流量、首次下地时间、住院时间均优于PLA组(P<0.05)。但SuperPATH组术中出血量、手术时间不及PLA组(P<0.05)。SuperPATH组完全负重时间显著早于PLA组(P<0.05)。术后3个月SuperPATH组VAS评分和Harris评分均显著优于PLA组,差异均有统计学意义(P<0.05),但末次随访时两组间上述评分的差异均无统计学意义(P>0.05)。末次随访时两组髋臼外翻角差异无统计学意义(P>0.05),但SuperPATH组前倾角显著大于PLA组(P<0.05)。[结论]与PLA入路比较,SuperPATH具有切口小、创伤小、疼痛轻、术后功能恢复快的优点,但手术时间较长。[Objective] To compare the early outcomes of primary total hip arthroplasty(THA) through SuperPATH approach versus posterolateral approach(PLA). [Methods] From July 2018 to December 2020, a total of 88 patients underwent primary THA in our hospital.Of them, 45 patients were undergoing THA through SuperPATH approach, however, 2 cases were changed to PLA intraoperatively, finally43 cases were enrolled in the SuperPATH group, while 43 patients had THA by using PLA approach. The perioperative, follow-up and imaging data were compared between the two groups. [Results] The SuperPATH group was superior to the PLA group in terms of incision length, postoperative drainage, time to return walking and hospital stay(P<0.05), whereas the former was inferior to the latter in intraoperative blood loss and operation time(P<0.05). The SuperPATH group resumed full-weight bearing activity significantly earlier than the PLA group(P<0.05). The SuperPATH group were significantly better than the PLA group in terms of the VAS and Harris scores at 3 months after surgery(P<0.05), whereas which became not statistical significant between the two groups at the latest follow-up(P>0.05). Regarding to radiographic assessment, there was no a significant difference in acetabular inclination between the two groups at the latest follow-up(P>0.05),but the anteversion angle of the SuperPATH group was significantly higher than that of the PLA group(P<0.05). [Conclusion] The SuperPATH has the advantages of smaller incision, less trauma, less pain and faster postoperative functional recovery, whereas longer operation time compared with PLA approach.

关 键 词：全髋关节置换术 后外侧入路 SuperPATH入路 

分 类 号：R687.4[医药卫生—骨科学]