两种入路行全髋关节置换术的疗效比较  

Efficacy comparison of total hip arthroplasty with two kinds of approaches

作　　者：史凯文 李永祥[1] SHI Kai-wen;LI Yong-xiang(Dept of Joint Surgery,the Second Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing,Jiangsu 210017,China)

机构地区：[1]南京中医药大学第二附属医院关节外科,江苏南京210017

出　　处：《临床骨科杂志》2023年第5期649-653,共5页Journal of Clinical Orthopaedics

摘　　要：目的比较前外侧入路和后外侧入路行全髋关节置换术治疗股骨颈骨折、髋关节骨关节炎的疗效。方法将67例股骨颈骨折及髋关节骨关节炎患者根据手术入路不同分为前外侧入路组(20例)和后外侧入路组(47例)。记录手术情况、并发症发生情况、髋臼杯外展角、髋臼杯前倾角及股骨偏心距。结果患者均获得随访,时间5个月~1年。手术时间前外侧入路组长于后外侧入路组(P<0.05)。切口长度前外侧入路组小于后外侧入路组(P<0.001)。输血量、血红蛋白改善量、术后3 d C-反应蛋白两组比较差异均无统计学意义(P>0.05)。后外侧入路组出现术中大结节骨折及术后假体脱位各1例。术后3 d,股骨偏心距前外侧入路组小于后外侧入路组(P<0.05);髋臼杯外展角、前倾角两组比较差异均无统计学意义(P>0.05)。结论与后外侧入路相比,采用前外侧入路全髋关节置换术治疗股骨颈骨折、髋关节骨关节炎,切口小,可以减少患者创伤,降低并发症发生风险。Objective To compare the efficacy of anterolateral approach and posterolateral approach undergoing THA in the treatment of femoral neck fracture and hip osteoarthritis.Methods The 67 patients with femoral neck fractures and hip osteoarthritis were divided into anterolateral approach group(20 cases)and posterolateral approach group(47 cases),according to different surgical approaches.Surgical conditions,complications,the abduction and anteversion of acetabular cup,femoral offset were recorded.Results All patients were followed up from 5 months to 1 year.The operative time of anterolateral approach was longer than that of posterolateral approach group(P<0.05).Incision length in anterolateral approach group was shorter than that in posterolateral approach group(P<0.001).There were no statistical differences between the two groups in the blood transfusion,hemoglobin improvement and C-reactive protein at 3 d after surgery(P>0.05).In the posterolateral approach group,there were 1 case of intraoperative greater tuberosity fracture and 1 case of prosthesis dislocation.At 3 d after surgery,the femoral offset in anterolateral approach group was smaller than that in posterolateral approach group(P<0.05).There were no statistical differences in the abduction and anteversion of the acetabular cup between the two groups(P>0.05).Conclusions Compared with the posterolateral approach,the anterolateral approach undergoing THA for the treatment of femoral neck fracture and hip osteoarthritis can reduce the patients′trauma and the risk of complications.

关 键 词：前外侧入路 后外侧入路 全髋关节置换术 股骨颈骨折 髋关节骨性关节炎 

分 类 号：R687.4[医药卫生—骨科学] R683.42[医药卫生—外科学] R684.3[医药卫生—临床医学]