Bertin Kim C, Röttinger Heinz
Utah Hip and Knee Center, Salt Lake City, Utah, USA.
Clin Orthop Relat Res. 2004 Dec(429):248-55.
Mini-incision total hip replacement seeks to eliminate some complications of traditional extensile exposure and also attempts to facilitate more rapid rehabilitation of patients after surgery. Different surgical approaches historically have been used to do hip replacement surgery. Anterior or anterolateral approaches have often been selected to decrease the risk of posterior dislocation. Traditional anterolateral approaches have divided the anterior portion of the gluteus medius and minimus and potentially jeopardized the superior gluteal nerve. These disadvantages have been associated with abductor weakness, prolonged limp and decreased patient satisfaction. To overcome these problems, a mini-incision approach was developed using the intermuscular plane between the gluteus medius and the tensor fascia lata. This intermuscular interval through a small incision provides good exposure for total hip replacement and preserves muscle integrity so that rehabilitation can be rapid and the posterior capsule remains intact so that posterior dislocation is less of an issue. The surgical technique for this new innovative approach is described in this article.
小切口全髋关节置换术旨在消除传统广泛暴露带来的一些并发症，并试图促进患者术后更快康复。历史上曾采用不同的手术入路进行髋关节置换手术。前侧或前外侧入路常被选用以降低后脱位风险。传统的前外侧入路会分开臀中肌和臀小肌的前部，可能会危及臀上神经。这些缺点与外展肌无力、跛行时间延长及患者满意度降低有关。为克服这些问题，人们开发了一种利用臀中肌和阔筋膜张肌之间肌间隙的小切口入路。通过小切口的这个肌间隙可为全髋关节置换提供良好的暴露，并保留肌肉完整性，从而实现快速康复，同时后关节囊保持完整，使后脱位问题不那么严重。本文描述了这种新的创新方法的手术技术。
