文章摘要
乔高山,顾英骏,朱成栋,等.前路经皮辅助关节囊上方入路全髋关节置换术应用探讨.骨科,2022,13(2): 135-139.
前路经皮辅助关节囊上方入路全髋关节置换术应用探讨
Application of Total Hip Arthroplasty through Anterior SuperPATH.
投稿时间:2021-09-15  
DOI:10.3969/j.issn.1674-8573.2022.02.008
中文关键词: 经皮辅助通道上方关节囊入路  直接前方入路  通道技术  前路辅助通道  全髋关节置换术
英文关键词: Supercapsalar percutaneously assisted total hip  Direct anterior approach  Percutaneous technique  Anterior path portal  Total hip arthroplasty
基金项目:扬州市“十三五”科教强卫专项经费资助项目(ZDRC201834)
作者单位E-mail
乔高山 扬州大学医学院附属仪征市人民医院骨关节外科江苏扬州 211400  
顾英骏 扬州大学医学院附属仪征市人民医院骨关节外科江苏扬州 211400  
朱成栋 扬州大学医学院附属仪征市人民医院骨关节外科江苏扬州 211400 dongdong801208@163.com 
朱乐银 扬州大学医学院附属仪征市人民医院骨关节外科江苏扬州 211400  
万春宝 扬州大学医学院附属仪征市人民医院骨关节外科江苏扬州 211400  
刘宝玉 扬州大学医学院附属仪征市人民医院骨关节外科江苏扬州 211400  
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中文摘要:
      目的 探讨前路经皮辅助关节囊上方入路(Anterior SuperPATH)全髋关节置换术(THA)的手术技术和早期疗效。方法 回顾性分析2019年11月至2020年10月在我院行THA的48例病人的临床资料,根据手术入路不同分为两组,23例采用前路经皮辅助关节囊上方入路者纳入Anterior SuperPATH组,25例采用经皮辅助通道上方关节囊入路者纳入SuperPATH组,记录并比较两组围手术期相关指标、髋臼杯位置、术后24 h疼痛视觉模拟量表(visual analogue scale,VAS)评分、术后6个月Harris评分、并发症发生情况。结果 病人随访6~25个月,平均为12.3个月。两组手术时间、术中出血量、下床活动时间、术后24 h VAS评分、髋臼假体外展角、术后6个月Harris评分的差异无统计学意义(P>0.05)。Anterior SuperPATH组髋臼前倾角位置比SuperPATH组更佳,差异有统计学意义(P<0.05)。Anterior SuperPATH组大腿外侧麻木1例,SuperPATH组脱位1例、股骨大转子骨折2例。结论 与SuperPATH组比较,Anterior SuperPATH组显示出相似的近期效果。前路经皮通道能够避免股骨的遮挡,直视化下操作,同轴髋臼侧处理,降低手术并发症,提高髋臼假体放置的精准性。
英文摘要:
      Objective To explore the surgical technique and early outcomes of total hip arthroplasty (THA) through Anterior SuperPATH. Methods The clinical data of 48 patients treated with initial THA in our hospital from November 2019 to October 2020 were analyzed. These patients were divided into Anterior SuperPATH group (23 cases) and SuperPATH group (25 cases) according to different surgical approaches. The data were compared between two groups in term of peri-operative related indexes, acetabular cup position, visual analogue scale (VAS) score 24 h after operation, Harris score 6 months after operation and the incidence of complications. Results All of patients were followed up for 12.3(6-25)months. There were no significant differences in operation time, intraoperative blood loss, postoperative landing activity time, postoperative 24 h VAS, component abduction and Harris scores 6 months after operation between two groups (P>0.05). Anterior SuperPATH was better than SuperPATH for abduction angle of acetabulum (P<0.05). One patient had lateral thigh numbness in Anterior SuperPATH group. One patient had dislocation, two greater trochanter fracture in SuperPATH group. Conclusion Early experience with an Anterior SuperPATH group demonstrates similar short-term outcomes compared with SuperPATH group. The use of the anterior percutaneous technique can avoid femoral occlusion, has also allowed for concentric acetabular cup reaming and impaction under direct visualization, minimize complications and improve the placemeny accuracy of acetabular prosthesis.
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