文章摘要
龚保军,窦强兵,李行星,袁先发,凤晓翔.后外侧结构重建对后外侧入路全髋关节置换术后早期脱位的影响.骨科,2019,10(2):101-104
后外侧结构重建对后外侧入路全髋关节置换术后早期脱位的影响
Preventive effects of posterolateral structure reconstruction on early dislocation in total hip arthroplasty through posterolateral approach
投稿时间:2018-10-22  
DOI:10.3969/j.issn.1674-8573.2019.02.004
中文关键词: 关节成形术,置换,髋  关节囊  外旋肌群  重建  后脱位
英文关键词: Arthroplasty, replacement, hip  Joint capsule  External rotator muscle  Reconstruction  Dislocation
基金项目:
作者单位E-mail
龚保军 安徽医科大学附属六安医院骨科安徽六安 237001 1548297422@qq.com 
窦强兵 安徽医科大学附属六安医院骨科安徽六安 237001  
李行星 安徽医科大学附属六安医院骨科安徽六安 237001  
袁先发 安徽医科大学附属六安医院骨科安徽六安 237001  
凤晓翔 安徽医科大学附属六安医院骨科安徽六安 237001  
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中文摘要:
      目的 探讨后外侧结构重建对后外侧入路全髋关节置换术(total hip arthroplasty, THA)后早期脱位的影响。方法 回顾性分析2015年1月至2018年1月于我院行后外侧入路初次THA的病人120例,根据术中是否修补关节囊及外旋肌群将病人分为两组:观察组60例,舌形切开关节囊,术中将关节囊及外旋肌群原位缝合在大转子后方及臀中肌肌腱附着处;对照组60例,切除后关节囊,术中未进行外旋肌群修补重建。术后3个月内发生的脱位定义为早期脱位,比较两种方法对术后早期脱位率的影响。记录并比较两组病人的手术时间、术腔引流量、髋关节Harris评分。结果 观察组手术时间为(51.6±9.5) min,对照组为(45.1±7.5) min,对照组手术时间短于观察组,差异有统计学意义(t=2.008,P=0.036)。观察组术腔引流量为(129.6±11.9) ml,对照组为(136.8±12.4) ml,差异无统计学意义(t=1.187,P=0.269)。观察组未发现早期脱位,对照组早期脱位4例(4/60,脱位率为6.667%),观察组术后Harris评分为(86.1±5.0)分,对照组为(85.9±5.5)分,差异无统计学意义(t=1.416,P=0.092)。结论 在后外侧入路THA过程中行后外侧结构重建的手术方式早期脱位率低,修补关节囊及外旋肌群对维持髋关节软组织平衡有一定意义。
英文摘要:
      Objective To explore the preventive effects of posterolateral structure reconstruction on early dislocation in total hip arthroplasty (THA) through posterolateral approach. Methods A total of 120 patients undergoing primary THA surgical procedures from January 2015 to January 2018 were included in this study. The patients were divided into two groups according to whether the posterior capsule and short external rotator muscles repair had been incorporated in the surgical procedure. Sixty patients in observation group were given “tongue”-shaped incision of the posterior capsule, and the capsule and the external rotation muscles were repaired during operation. In control group (60 cases), the posterior capsule was excised and the external rotation muscles were not repaired during THA surgery. Early dislocation was defined as the dislocation occurring within 3 months after operation. Effects of two surgery methods on early dislocation were compared after arthroplasty. The operative time, drainage volume and Harris hip score were recorded and compared between the two groups. Results Operation time was (51.6±9.5) min in the observation group and (45.1±7.5) min in the control group with the difference being significant (t=2.008, P=0.036). The drainage volume after surgery was (129.6±11.9) ml in the observation group and (136.8±12.4) ml in the control group (t=1.187, P=0.269). No dislocation occurred in observation group, and 4 patients had dislocation (4/60, 6.667%) in the control group. Harris hip score was 86.1±5.0 in the observation group and 85.9±5.5 in control group after surgery (t=1.416, P=0.092). Conclusion In the process of THA through the posterolateral approach, the rate of early dislocation in posterolateral structure reconstruction is lower than in non-reconstruction. Repair of articular capsule and external rotator muscle group has certain significance in maintaining the soft tissue balance of hip joint.
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