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用于全髋关节置换术的髋关节微创入路:“OrthoMIT”项目范围内的最新技术,该项目旨在开发用于智能介入骨科手术和创伤学的集成平台

[Minimally invasive approaches to the hip joint for total hip arthroplasty: state of the art within the scope of the "OrthoMIT" project for the development of an integrated platform for smart interventional orthopaedic surgery and traumatology].

作者信息

Gravius S, Wirtz D C, Maus U, Andereya S, Müller-Rath R, Mumme T

机构信息

Universitätsklinik für Orthopädie und Unfallchirurgie, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn.

出版信息

Z Orthop Unfall. 2007 Sep-Oct;145(5):608-14. doi: 10.1055/s-2007-965691.

Abstract

INTRODUCTION

Total hip arthroplasty within the field of minimally invasive surgery (MIS) is discussed controversially in the current literature. Potential advantages of MIS should be minimised soft-tissue trauma and thereby less operative loss of blood as well as postoperative pain, resulting in a faster rehabilitation with reduced hospital stay.

METHODS

In this article the different minimally invasive approaches to the hip joint for total hip arthroplasty, including anterior, anterolateral, lateral, posterolateral and medial approaches, are reviewed. Potential advantages and disadvantages as well as published results are discussed against the background of evidence-based medicine.

RESULTS

The results available so far on minimally invasive approaches for total hip arthroplasty are almost exclusively extracted from retrospective studies and case series. However, the results of randomised controlled studies in an appreciable number of patients are still lacking.

CONCLUSION

Minimally invasive approaches to the hip joint have opened a new era in total hip arthroplasty. The current literature does not allow a final judgment about the advantages of MIS in total hip replacement. So far, increasing complications of MIS are reported in the current literature. Until evidence-based data are available, it is strongly recommended that these techniques should only be applied by experienced surgeons.

摘要

引言

在当前文献中,关于微创外科(MIS)领域内的全髋关节置换术存在争议。MIS的潜在优势应该是将软组织创伤降至最低,从而减少术中失血以及术后疼痛,进而实现更快的康复并缩短住院时间。

方法

在本文中,对用于全髋关节置换术的不同微创入路髋关节方法进行了综述,包括前侧、前外侧、外侧、后外侧和内侧入路。在循证医学的背景下讨论了潜在的优缺点以及已发表的结果。

结果

目前关于全髋关节置换术微创入路的现有结果几乎完全来自回顾性研究和病例系列。然而,仍缺乏大量患者的随机对照研究结果。

结论

髋关节的微创入路开启了全髋关节置换术的新纪元。当前文献无法对MIS在全髋关节置换中的优势做出最终判断。目前文献中报道了MIS并发症不断增加的情况。在获得循证数据之前,强烈建议这些技术仅由经验丰富的外科医生应用。

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