摘要
目的比较直接前入路(DAA)与经典后外侧入路(PLA)行全髋关节置换术后的假体位置和临床疗效。方法将行全髋关节置换术的124例股骨头坏死或骨关节炎患者,根据不同手术入路分为DAA组62例和经典PLA组(PLA组)62例。比较两组患者术后影像学指标(髋臼外展角、前倾角、臼杯位于安全区比例、股骨假体居中率)和手术时间、切口长度、术中出血量、术后引流量、术后下地时间、疼痛视觉模拟量表(VAS)评分、Harris功能评分、术后并发症发生情况。结果DAA组患者的手术时间长于PLA组,手术切口长度、术中失血量、术后引流量、术后下地时间均短于或少于PLA组,臼杯位于安全区的比例高于PLA组,且术后1个月、3个月、6个月DAA组的疼痛VAS评分均低于PLA组,Harris功能评分均高于PLA组(均P<0.05),但两组患者的外展角、前倾角及股骨假体居中比例、术后并发症发生率比较,差异均无统计学意义(均P>0.05)。结论相比于PLA入路,采用DAA入路行全髋关节置换术对患者肌肉损伤程度更轻,假体位置(臼杯)处于安全区比例更高,术后疼痛更轻,利于患者功能恢复,安全性高。
Objective To compare prosthesis position and clinical efficacy after total hip arthroplasty between direct anterior approach(DAA)and classic posterolateral approach(PLA).Methods A total of 124 patients with femoral head necrosis or osteoarthritis who underwent total hip arthroplasty were divided into DAA group(62 cases)and classic PLA group(PLA group,62 cases)according to different surgical approaches.The related measurements were compared between the two groups,including postoperative imaging indexes(acetabular abduction angle,anteversion angle,proportion of cases with acetabular cups located in the safety zone,and centralization rate of femoral prosthesis),operation duration,incision length,intraoperative bleeding volume,postoperative drainage volume,postoperative ambulation time,the Visual Analogue Scale(VAS)pain score,Harris function score and incidence of postoperative complications.Results Compared with the PLA group,the DAA group had longer operation duration,shorter length of surgical incision,less intraoperative blood loss and postoperative drainage volume,shorter postoperative ambulation time,higher proportion of cases with acetabular cups located in the safety zone,as well as lower VAS pain scores and higher Harris function scores one,three and six months after operation(all P<0.05),but there were no statistically significant differences between the two groups in abduction angle,anteversion angle,proportion of femoral prosthesis centralization,or incidence rate of postoperative complications(all P>0.05).Conclusion Compared with PLA,total hip arthroplasty using DAA has milder muscle damage,higher proportion of prosthesis(acetabular cup)located in the safety zone,and milder postoperative pain in the patients,which is in favor of patients′function recovery and achieves high safety.
作者
陈永杰
谭伦
张红庆
翁贞
焦胜
罗显红
吴明鑫
彭育超
邱进彪
CHEN Yong-jie;TAN Lun;ZHANG Hong-qing;WENG Zhen;JIAO Sheng;LUO Xian-hong;WU Ming-xin;PENG Yu-chao;QIU Jin-biao(Department of Orthopedic Surgery,Rongxian People′s Hospital,Zigong 643100,China;Department of Orthopaedics,the Fourth People′s Hospital of Zigong City,Zigong 643000,China)
出处
《广西医学》
CAS
2021年第5期556-560,共5页
Guangxi Medical Journal
关键词
全髋关节置换术
直接前入路
经典后外侧入路
外展角
前倾角
康复
假体位置
疗效
Total hip arthroplasty
Direct anterior approach
Classic posterolateral approach
Abduction angle
Anteversion angle
Rehabilitation
Prosthesis position
Efficacy
