Kim Yong Sik, Kwon Soon Yong, Sun Doo Hoon, Han Suk Ku, Maloney William J
Department of Orthopaedic Surgery, Kang-Nam St. Mary's Hospital, The Catholic University of Korea, Banpo-Dong 505, Seocho-Gu, Seoul 137-040, Korea.
Clin Orthop Relat Res. 2008 Feb;466(2):294-9. doi: 10.1007/s11999-007-0056-8. Epub 2008 Jan 10.
We modified the posterior approach by preserving the external rotator muscles to enhance joint stability after primary THA. We asked whether this modified posterior approach would have a lower dislocation rate than the conventional posterior approach, with and without a repair of external rotator muscles. We retrospectively divided 557 patients (670 hips) who had undergone primary THA into three groups based on how the external rotator muscles had been treated during surgery: (1) not repaired after sectioning, (2) repaired after sectioning, or (3) not sectioned and preserved. The minimum followup was 1 year. In the group with preserved external rotator muscles, we observed no dislocations; in comparison, the dislocation rates for the repaired rotator group and the no-repair group were 3.9% and 5.3%, respectively. This modified posterior approach, which preserves the short external rotator muscles, seemed effective in preventing early dislocation after primary THA.
Level III, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
我们通过保留外旋肌改良了后路手术方法，以增强初次全髋关节置换术后的关节稳定性。我们探讨了这种改良后路手术方法在修复或不修复外旋肌的情况下，脱位率是否低于传统后路手术方法。我们回顾性地将557例行初次全髋关节置换术的患者（670髋）根据术中对外旋肌的处理方式分为三组：（1）切断后未修复，（2）切断后修复，或（3）未切断并保留。最短随访时间为1年。在保留外旋肌的组中，我们未观察到脱位；相比之下，修复外旋肌群组和未修复组的脱位率分别为3.9%和5.3%。这种保留短外旋肌的改良后路手术方法似乎能有效预防初次全髋关节置换术后的早期脱位。
III级，治疗性研究。有关证据水平的完整描述，请参阅作者指南。
