Dutka Julian, Sosin Paweł, Libura Marek, Skowronek Paweł
Oddział Chirurgii Ortopedyczno-Urazowej Specjalistycznego Szpitala im. St. Zeromskiego, Kraków.
Ortop Traumatol Rehabil. 2007 Jan-Feb;9(1):39-45.
Evaluation of: 1. early clinical and radiographic results of total hip arthroplasty (THA) through a standard lateral direct approach, 2. early clinical and radiographic results of THA through a minimal lateral approach, 3. comparison of the results of THA in these two groups.
120 THAs (60 cementless and 60 cemented) done in 120 patients due to degenerative changes were evaluated prospectively. 60 THAs were done through a minimal lateral approach and constituted a study group. 60 THAs were done through a direct lateral approach and constituted a control group. The mean age of the 120 patients (98 women and 22 men) was 45 y.o. (range: 32-67 y.o.). The duration of follow-up in the study group was from 6 to 12 months (mean: 8.5 months). The duration of follow-up in the control group was from 10 to 16 months (mean: 10.5 months). Mean preoperative functional status of the study group was 44.5 points according to the Harris hip score. Radiographic evaluation of the results was done according to the criteria of the Joint Committee of the Hip Society, AAOS and SICOT.
6 months after THA, clinical results were 92 pts in the study group and 88 pts in the control group. Radiographic outcomes were very good in all 120 patients from both arms: there were no differences between the control and study group. The incidence of complications was similar in both groups.
Minimally invasive THA demonstrated its value in the treatment of degenerative changes of the hip joint with regard to short-term outcomes. The clinical and radiographic outcomes were comparable between the standard and minimally invasive approaches. Success with THA using a minimally invasive approach depends on excellent operative technique and experience with standard hip approaches rather than on the use of special instruments.
评估：1. 经标准外侧直接入路行全髋关节置换术（THA）的早期临床和影像学结果；2. 经微创外侧入路行THA的早期临床和影像学结果；3. 比较这两组THA的结果。
对120例因退行性变而行THA的患者（120例手术，60例非骨水泥型和60例骨水泥型）进行前瞻性评估。60例THA经微创外侧入路完成，构成研究组。60例THA经直接外侧入路完成，构成对照组。120例患者（98例女性和22例男性）的平均年龄为45岁（范围：32 - 67岁）。研究组的随访时间为6至12个月（平均：8.5个月）。对照组的随访时间为10至16个月（平均：10.5个月）。根据Harris髋关节评分，研究组术前平均功能状态为44.5分。根据髋关节协会联合委员会、美国矫形外科医师学会（AAOS）和国际骨科学会（SICOT）的标准对结果进行影像学评估。
THA术后6个月，研究组的临床结果为92分，对照组为88分。两组120例患者的影像学结果均非常好：对照组和研究组之间无差异。两组并发症的发生率相似。
就短期结果而言，微创THA在治疗髋关节退行性变方面显示出其价值。标准入路和微创入路的临床和影像学结果具有可比性。采用微创入路行THA的成功取决于精湛的手术技术和标准髋关节入路的经验，而非特殊器械的使用。
