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微创全髋关节置换术:系统评价。

Minimally invasive total hip arthroplasty: a systematic review.

机构信息

Department of Orthopaedic Surgery, Shanghai Sixth People's Hospital, Medical College, Shanghai Jiaotong University, Shanghai, China.

出版信息

Int Orthop. 2009 Dec;33(6):1473-81. doi: 10.1007/s00264-009-0743-z. Epub 2009 Mar 11.

DOI:10.1007/s00264-009-0743-z
PMID:19277652
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2899157/
Abstract

The purpose of this study was to compare the operative outcome between mini and standard incisions in total hip arthroplasty (THA). We identified 12 randomised or quasi-randomised control trials (RCT or qRCT) published between 1996 and 2008. Subgroup and sensitivity analyses were performed to evaluate the differences in results for surgical approach, trial quality, and follow-up duration. Operative time and blood loss were significantly reduced in the mini-incision group for studies with the posterior or posterolateral approach. Concerning postoperative complications, there were no significant differences between the two groups with no significant heterogeneity. No differences were observed between the two groups for Harris hip score and radiographic results except for cup anterversion. Although mini-incision appeared to have similar outcomes compared to standard incision, the follow-up is short-term according to current standards in THA. High-quality studies are required to compare the outcomes of these two procedures.

摘要

本研究旨在比较全髋关节置换术(THA)中小切口与标准切口的手术效果。我们共纳入了 1996 年至 2008 年间发表的 12 项随机或半随机对照试验(RCT 或 qRCT)。我们进行了亚组和敏感性分析,以评估手术入路、试验质量和随访时间的结果差异。对于后路或后外侧入路的研究,小切口组的手术时间和失血量显著减少。在术后并发症方面,两组之间没有显著差异,且异质性不显著。除了杯前倾外,两组之间的 Harris 髋关节评分和影像学结果没有差异。虽然小切口与标准切口相比似乎具有相似的结果,但根据当前 THA 的标准,随访时间是短期的。需要高质量的研究来比较这两种手术的结果。

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本文引用的文献

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A lateral minimal-incision technique in total hip replacement: a prospective, randomizes, controlled trial.全髋关节置换术中的外侧小切口技术:一项前瞻性、随机、对照试验。
Hip Int. 2007 Jan-Mar;17(1):4-8. doi: 10.1177/112070000701700102.
2
Comparison of skin blood flow between mini- and standard-incision approaches during total hip arthroplasty.全髋关节置换术中微创与标准切口入路的皮肤血流比较。
J Arthroplasty. 2008 Oct;23(7):1045-9. doi: 10.1016/j.arth.2007.09.009. Epub 2008 Mar 4.
3
[A comparison of operative invasiveness in minimally invasive anterolateral hip replacement (MIS-AL) and standard hip procedure, using biochemical markers].[使用生化标志物比较微创前外侧髋关节置换术(MIS-AL)与标准髋关节手术的手术侵袭性]
Acta Chir Orthop Traumatol Cech. 2008 Feb;75(1):16-20.
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Initial results with a mini-posterior approach for total hip arthroplasty.全髋关节置换术微小后路入路的初步结果。
Int Orthop. 2007 Aug;31 Suppl 1(Suppl 1):S17-20. doi: 10.1007/s00264-007-0435-5.
5
Posterior single-incision approach to minimally invasive total hip arthroplasty.微创全髋关节置换术的后入路单切口方法
Int Orthop. 2007 Aug;31 Suppl 1(Suppl 1):S1-5. doi: 10.1007/s00264-007-0436-4.
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The science of minimally invasive total hip arthroplasty.微创全髋关节置换术的科学
Clin Orthop Relat Res. 2007 Oct;463:74-84. doi: 10.1097/BLO.0b013e3181468766.
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J Bone Joint Surg Am. 2007 Jun;89(6):1153-60. doi: 10.2106/JBJS.F.00940.
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Surgical approaches in total hip arthroplasty: a review of the mini-incision and MIS literature.全髋关节置换术的手术入路:微创切口及微创技术文献综述
Bull NYU Hosp Jt Dis. 2007;65(1):5-18.
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Laparoscopic cholecystectomy versus mini-laparotomy cholecystectomy: a meta-analysis of randomised control trials.腹腔镜胆囊切除术与小切口开腹胆囊切除术:随机对照试验的荟萃分析
Surg Endosc. 2007 Aug;21(8):1294-300. doi: 10.1007/s00464-007-9210-3. Epub 2007 May 22.
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Total hip arthroplasty through a minimally invasive lateral approach--our experience and early results.经微创外侧入路行全髋关节置换术——我们的经验及早期结果
Ortop Traumatol Rehabil. 2007 Jan-Feb;9(1):39-45.