Pagnano Mark W, Trousdale Robert T, Meneghini R Michael, Hanssen Arlen D
Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
Clin Orthop Relat Res. 2006 Dec;453:156-9. doi: 10.1097/01.blo.0000238858.38992.2d.
The two-incision total hip arthroplasty (THA) technique has been touted as offering substantially faster recovery than other methods of THA, but direct comparison studies in similar groups of patients have not been done. We sought to determine if there was a difference in the early functional outcome after a two-incision THA compared to a mini-posterior THA as measured by the time to reach defined milestones of daily activity. We also evaluated which procedure the patients preferred. Twenty-six patients underwent staged bilateral total hip arthroplasties with a two-incision minimally invasive THA on one hip and a mini-posterior THA on the contralateral hip. The same comprehensive anesthesia and rapid rehabilitation protocol was used after each operation. Patients were reviewed retrospectively a minimum of 6 months after the second total hip arthroplasty. There were no differences in the time to discontinue ambulatory aids, return to driving, climb stairs, return to work, or walk 1/2 mile. Sixteen of 26 patients preferred the mini-posterior total hip arthroplasty and two patients had no preference. The added surgical technical difficulty of the two-incision minimally invasive total hip arthroplasty was not rewarded with an earlier return to functional activities and more patients preferred their mini-posterior total hip arthroplasty.
双切口全髋关节置换术（THA）技术被吹捧为比其他THA方法恢复得快得多，但尚未对相似患者群体进行直接比较研究。我们试图确定，与小切口后外侧THA相比，双切口THA术后早期功能结果是否存在差异，通过达到日常活动特定里程碑的时间来衡量。我们还评估了患者更喜欢哪种手术方式。26例患者接受了分期双侧全髋关节置换术，一侧髋关节采用双切口微创THA，对侧髋关节采用小切口后外侧THA。每次手术后均采用相同的综合麻醉和快速康复方案。在第二次全髋关节置换术后至少6个月对患者进行回顾性评估。在停用助行器、恢复驾驶、爬楼梯、恢复工作或步行半英里的时间方面没有差异。26例患者中有16例更喜欢小切口后外侧全髋关节置换术，2例患者无偏好。双切口微创全髋关节置换术增加的手术技术难度并没有换来更早恢复功能活动，更多患者更喜欢小切口后外侧全髋关节置换术。
