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-  2017 

直接前方入路人工全髋关节置换术的中期疗效研究

DOI: doi:10.7507/1002-1892.201705011

Keywords: 直接前方入路, 人工全髋关节置换术, 中期疗效

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Abstract:

目的通过与传统后外侧入路比较,总结直接前方入路(direct anterior approach,DAA)人工全髋关节置换术的中期疗效。方法回顾分析 2009 年 1 月—2010 年 12 月 110 例(110 髋)行人工全髋关节置换术并随访达 5 年的患者临床资料,其中采用 DAA 手术 55 例(DAA 组),后外侧入路手术 55 例(PL 组)。两组患者性别、年龄、体质量指数、髋关节基础疾病以及术前 Harris 评分等一般资料比较,差异均无统计学意义(P>0.05)。记录并比较两组手术时间、术中出血量和住院时间,观察并发症发生情况;采用 Harris 评分评价髋关节功能恢复情况。结果DAA 组手术时间及住院时间与 PL 组比较,差异无统计学意义(t=0.145,P=0.876;t=1.305,P=0.093);但术中出血量较 PL 组明显减少(t=2.314,P=0.032)。所有患者均获随访,随访时间 5~7 年,平均 5.97 年。 DAA 组 5 例(9.1%)、PL 组 3 例(5.5%)发生手术相关并发症,并发症发生率比较差异无统计学意义(χ2=0.539,P=0.463)。术后 6 个月 DAA 组 Harris 评分显著高于 PL 组 (t=2.296,P=0.014),1 年及 5 年两组 Harris 评分比较差异均无统计学意义(t=1.375,P=0.130;t=0.905,P=0.087)。进一步分析术后 6 个月 DAA 组 Harris 评分中关节功能评分显著优于 PL 组(t=1.087,P=0.034),而疼痛和活动范围评分两组比较差异无统计学意义(t=1.872,P=0.760;t=1.059,P=0.091)。结论DAA 人工全髋关节置换术具有手术出血少、术后患者康复更快的优点,其早期疗效优于传统后外侧入路手术,但中期疗效无明显优势

References

[1]  1. Post ZD, Orozco F, Diaz-Ledezma C, et al. Direct Anterior Approach for Total Hip Arthroplasty: Indications, Technique, and Results. J Am Acad Orthop Surg, 2014, 22(9): 595-603.
[2]  2. Rachbauer F, Kain MS, Leunig M. The history of the anterior approach to the hip. Orthop Clin North Am, 2009, 40(3): 311-320.
[3]  6. 桑伟林, 朱力波, 马金忠, 等. 微创直接前入路全髋关节置换术. 国际骨科学杂志, 2010, 31(5): 266-267.
[4]  8. Sang W, Zhu L, Ma J, et al. The Influence of Body Mass Index and Hip Anatomy on Direct Anterior Approach of Total Hip Replacement. Med Princ Pract, 2016, 25(6): 555-560.
[5]  9. Mirza AJ, Lombardi AV Jr, Morris MJ, et al. A mini-anterior approach to the hip for total joint replacement: optimising results: improving hip joint replacement outcomes. Bone Joint J, 2014, 96-B(11 Supp A): 32-35.
[6]  10. Tsukada S, Wakui M. Lower Dislocation Rate Following Total Hip Arthroplasty via Direct Anterior Approach than via Posterior Approach: Five-Year-Average Follow-Up Results. Open Orthop J, 2015, 15(9): 157-162.
[7]  11. Sheth D, Cafri G, Inacio MC, et al. Anterior and Anterolateral Approaches for THA Are Associated With Lower Dislocation Risk Without Higher Revision Risk. Clin Orthop Relat Res, 2015, 473(11): 3401-3408.
[8]  13. Meneghini RM, Pagnano MW, Trousdale RT, et al. Muscle damage during MIS total hip arthroplasty: Smith-Petersen versus posterior approach. Clin Orthop Relat Res, 2006, 453: 293-298.
[9]  16. Barnett SL, Peters DJ, Hamilton WG, et al. Is the Anterior Approach Safe? Early Complication Rate Associated with 5090 Consecutive Primary Total Hip Arthroplasty Procedures Performed Using the Anterior Approach. J Arthroplasty, 2016, 31(10): 2291-2294.
[10]  18. Rudin D, Manestar M, Ullrich O, et al. The Anatomical Course of the Lateral Femoral Cutaneous Nerve with Special Attention to the Anterior Approach to the Hip Joint. J Bone Joint Surg (Am), 2016, 98(7): 561-567.
[11]  19. Homma Y, Baba T, Sano K, et al. Lateral femoral cutaneous nerve injury with the direct anterior approach for total hip arthroplasty. Int Orthop, 2016, 40(8): 1587-1593.
[12]  20. Grob K, Manestar M, Ackland T, et al. Potential Risk to the Superior Gluteal Nerve During the Anterior Approach to the Hip Joint: An Anatomical Study. J Bone Joint Surg (Am), 2015, 97(17): 1426-1431.
[13]  21. den Hartog YM, Mathijssen NM, Vehmeijer SB. The less invasive anterior approach for total hip arthroplasty: a comparison to other approaches and an evaluation of the learning curve-a systematic review. Hip Int, 2016, 26(2): 105-120.
[14]  3. Taunton MJ, Mason JB, Odum SM, et al. Direct anterior total hip arthroplasty yields more rapid voluntary cessation of all walking aids: a prospective, randomized clinical trial. J Arthroplasty, 2014, 29(9 Suppl): 169-172.
[15]  4. Christensen CP, Jacobs CA. Comparison of Patient Function during the First Six Weeks after Direct Anterior or Posterior Total Hip Arthroplasty (THA): A Randomized Study. J Arthroplasty, 2015, 30(9 Suppl): 94-97.
[16]  5. Mohan R, Yi PH, Hansen EN. Evaluating online information regarding the direct anterior approach for total hip arthroplasty. J Arthroplasty, 2015, 30(5): 803-807.
[17]  7. 桑伟林, 朱力波, 陆海明, 等. 直接前入路与后外侧入路全髋关节置换术的对比研究. 中华关节外科杂志 (电子版), 2015, 9(5): 584-588.
[18]  12. Lanting BA, Odum SM, Cope RP, et al. Incidence of perioperative events in single setting bilateral direct anterior approach total hip arthroplasty. J Arthroplasty, 2015, 30(3): 465-467.
[19]  14. Bergin PF, Doppelt JD, Kephart CJ, et al. Comparison of minimally invasive direct anterior versus posterior total hip arthroplasty based on inflammation and muscle damage markers. J Bone Joint Surg (Am), 2011, 93(15): 1392-1398.
[20]  15. Grob K, Monahan R, Gilbey H, et al. Distal extension of the direct anterior approach to the hip poses risk to neurovascular structures: an anatomical study. J Bone Joint Surg (Am), 2015, 97(2): 126-132.
[21]  17. De Geest T, Fennema P, Lenaerts G, et al. Adverse effects associated with the direct anterior approach for total hip arthroplasty: a Bayesian meta-analysis. Arch Orthop Trauma Surg, 2015, 135(8): 1183-1192.

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