Rachbauer F
Klinik für Orthopädie, Medizinische Universität, Innsbruck.
Orthopade. 2005 Nov;34(11):1103-4, 1106-8, 1110. doi: 10.1007/s00132-005-0854-1.
Minimally invasive total hip arthroplasty (THA) aims at reduction of tissue damage to accelerate recovery. The anterior approach promises optimal soft tissue preservation.
Safety and feasibility of minimally invasive THA via an anterior approach without the use of an orthopedic table was tested in a prospective cohort study on 100 consecutive patients. There were no exclusion criteria, and cementless and cemented techniques were employed.
No second incision was needed and neither nerve palsy nor dislocation was observed. The inclination angle of the cup was a median of 44.1 degrees and the position of the stem a median of 0 degrees varus/valgus. Short, satisfactory scars, little blood loss and postoperative pain, accelerated rehabilitation, and early discharge were noted. There were six cases of a permanent lesion of the lateral femoral cutaneous nerve.
The proposed technique is safe and allows correct positioning of the cup and stem. It can be performed in a reasonable amount of time and blood loss is little.
微创全髋关节置换术(THA)旨在减少组织损伤以加速康复。前路入路有望实现最佳的软组织保留。
在一项针对100例连续患者的前瞻性队列研究中,测试了不使用骨科手术台通过前路进行微创THA的安全性和可行性。没有排除标准,采用了非骨水泥和骨水泥技术。
无需二次切口,未观察到神经麻痹或脱位。髋臼杯的倾斜角度中位数为44.1度,股骨柄的位置内翻/外翻角度中位数为0度。观察到切口短且美观、失血少、术后疼痛轻、康复加速以及早期出院。有6例股外侧皮神经永久性损伤。
所提出的技术是安全的,能够使髋臼杯和股骨柄正确定位。该技术可在合理的时间内完成,且失血少。