Oinuma Kazuhiro, Tamaki Tatsuya, Miura Yoko, Kaneyama Ryutaku, Shiratsuchi Hideaki
Funabashi Orthopedic Hospital, Funabashi City, Chiba, Japan.
J Arthroplasty. 2014 Mar;29(3):626-9. doi: 10.1016/j.arth.2013.07.038. Epub 2013 Aug 30.
Between September 2006 and June 2011, 1521 primary total hip arthroplasties were performed using the direct anterior approach on a standard surgical table. In 12 hips, subtrochanteric shortening osteotomy was required. Full weight bearing was allowed 1 week after surgery. The mean follow-up period was 3.7 years. All patients limped preoperatively, but no patient had a positive Trendelenburg or Duchenne limp at the last follow-up. On the basis of our findings, we believe that the direct anterior approach is a safe and reproducible technique for total hip arthroplasty with subtrochanteric shortening osteotomy in the case of Crowe grade 4 dysplasia. It allows the steady recovery of the abductor muscles, a shorter period to postoperative partial weight bearing, and elimination of limping.
2006年9月至2011年6月期间，在标准手术台上采用直接前路入路进行了1521例初次全髋关节置换术。其中12例髋关节需要进行转子下缩短截骨术。术后1周允许完全负重。平均随访期为3.7年。所有患者术前均有跛行，但在最后一次随访时，没有患者出现阳性Trendelenburg征或杜兴氏跛行。基于我们的研究结果，我们认为对于Crowe 4级发育不良病例，直接前路入路是一种安全且可重复的全髋关节置换术技术，可同时进行转子下缩短截骨术。它能使外展肌稳定恢复，缩短术后部分负重的时间，并消除跛行。
