Department of Orthopaedic Surgery, Stanford University Medical Center, 450 Broadway Street, Pavilion A, Redwood City, CA 94063, USA.
Clin Orthop Relat Res. 2010 Sep;468(9):2372-6. doi: 10.1007/s11999-010-1300-1.
Minimal incision total hip arthroplasty (MI THA) techniques were developed to decrease postoperative pain and recovery time. Although these techniques have increased in popularity, the long-term survivorship of these procedures is unknown.
QUESTIONS/PURPOSES: We therefore investigated whether the time to revision in our referral practice was shorter for patients who underwent primary MI THA compared to primary traditional THA.
We retrospectively reviewed 46 revision THAs performed during a 3-year period. We excluded revisions performed for infection and rerevisions. Patients with incisions less than or equal to 10 cm were defined as having had MI THA. Fifteen of the 46 patients (33%) had undergone primary MI THA. At the time of primary index THA, the mean ages of the MI and non-MI patients were 65 years and 55 years, respectively.
The mean time to revision was 1.4 years for the MI patients compared with 14.7 years for the non-MI patients. Twelve of the 15 patients having MI THA required revision within 2 years of primary THA compared to 4 of the 31 patients without MI surgery (OR = 26.5, 95% CI 4.4-160.0). There were no differences between the groups with regard to age, gender, or body mass index. The most common reasons for revision in the MI THA group were intraoperative fracture and failure of femoral component osseointegration.
Our data suggest MI THA may be a risk factor for early revision surgery and the long-term survival therefore may be lower than that for non-MI surgery.
Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
微创全髋关节置换术（MI THA）技术的发展旨在减少术后疼痛和恢复时间。尽管这些技术越来越受欢迎，但这些手术的长期存活率尚不清楚。
问题/目的：因此，我们调查了在我们的转诊实践中，与接受传统初次 THA 的患者相比，初次 MI THA 的患者的翻修时间是否更短。
我们回顾性分析了 3 年内进行的 46 例翻修 THA。我们排除了因感染和再翻修而进行的翻修。切口小于或等于 10cm 的患者被定义为接受了 MI THA。46 例患者中有 15 例（33%）接受了初次 MI THA。初次指数 THA 时，MI 组和非 MI 组患者的平均年龄分别为 65 岁和 55 岁。
MI 组的平均翻修时间为 1.4 年，而非 MI 组为 14.7 年。15 例 MI THA 中有 12 例在初次 THA 后 2 年内需要翻修，而非 MI 手术组中有 4 例（OR=26.5，95%CI 4.4-160.0）。两组在年龄、性别或体重指数方面没有差异。MI THA 组最常见的翻修原因是术中骨折和股骨组件骨整合失败。
我们的数据表明，MI THA 可能是早期翻修手术的危险因素，因此长期存活率可能低于非 MI 手术。
III 级，治疗研究。有关证据水平的完整描述，请参见作者指南。
