Nakata Katsuya, Nishikawa Masataka, Yamamoto Koji, Hirota Shigeaki, Yoshikawa Hideki
Department of Orthopaedic Surgery, Toyonaka Municipal Hospital, Osaka, Japan.
J Arthroplasty. 2009 Aug;24(5):698-704. doi: 10.1016/j.arth.2008.04.012. Epub 2008 Jun 13.
We classified 182 consecutive patients (195 hips) treated by primary cementless minimally invasive total hip arthroplasty (MIS-THA) into 2 groups via the surgical approaches: direct anterior approach (DAA, 99 hips) and a mini-posterior approach (MPA, 96 hips). Ninety-nine percent of the cups in the DAA group and 91% in the MPA group had been implanted within the safe zone (P = .008). Patients in the DAA group could get single-leg stance of more than 5 seconds by 16.6 days (P = .0004), had positive Tredelenburg's sign by 29%, got 50-m walking time of 52.3 seconds (P = .017), and showed improvement in the use of assistive walking aids (P = .031) at 3 weeks postoperatively. The results of this study suggest more rapid recovery for hip function and gait ability after MIS-THA via a DAA when compared to an MPA.
我们将182例接受初次非骨水泥微创全髋关节置换术（MIS-THA）治疗的连续患者（195髋）根据手术入路分为两组：直接前路入路（DAA，99髋）和微创后路入路（MPA，96髋）。DAA组99%的髋臼杯和MPA组91%的髋臼杯植入于安全区内（P = 0.008）。DAA组患者在术后16.6天即可实现单腿站立超过5秒（P = 0.0004），29%出现臀中肌步态阳性，50米步行时间为52.3秒（P = 0.017），且在术后3周辅助步行器具使用情况有所改善（P = 0.031）。本研究结果表明，与MPA相比，MIS-THA采用DAA时髋关节功能和步态能力恢复更快。
