Griffiths D E, Acton K, Hull J B
Department of Orthopaedics, Frimley Park Hospital NHS Foundation Trust, Camberley, Surrey.
Surgeon. 2008 Apr;6(2):115-9. doi: 10.1016/s1479-666x(08)80075-3.
Hip resurfacing arthroplasty can be performed through anterolateral or posterior approaches. Concerns have been raised about the posterior approach due to the perceived loss ofthe crucial posterolateral blood supply to the femoral head and neck. The trochanteric 'flip' osteotomy method, pioneered by Ganz, with a blood supply conserving capsulotomy was therefore developed to allow this operation to be performed through an anterolateral incision. The repair of the trochanteric osteotomy has, however, shown an incidence of non-union and does not permit full weight bearing in the immediate post-operative period. Through our current practice we have developed a technique for hip resurfacing through an anterolateral modified Hardinge approach that does not require trochanteric osteotomy, preserves the femoral neck blood supply and allows full weight bearing in the immediate post operative-period.
髋关节表面置换术可通过前外侧或后外侧入路进行。由于人们认为股骨头和颈部关键的后外侧血供会丧失,后外侧入路引发了诸多担忧。因此,由甘茨首创的大转子“翻转”截骨术方法,采用保留血供的关节囊切开术,以便能通过前外侧切口进行该手术。然而,大转子截骨术的修复显示出不愈合的发生率,且在术后即刻不允许完全负重。通过我们目前的实践,我们开发了一种通过前外侧改良哈丁格入路进行髋关节表面置换的技术,该技术无需大转子截骨,保留了股骨颈血供,并允许在术后即刻完全负重。