Vicente José Ricardo Negreiros, Miyahara Helder Souza, Luzo Carlos Malheiros, Gurgel Henrique Melo, Croci Alberto Tesconi
Instituto de Ortopedia e Traumatologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
Rev Bras Ortop. 2014 Dec 31;50(1):77-82. doi: 10.1016/j.rboe.2014.12.005. eCollection 2015 Jan-Feb.
To evaluate the medium-term clinical-functional results (minimum follow-up of six years) from total uncemented hip arthroplasty performed by means of a posterior minimally invasive access, in comparison with the traditional right lateral access.
In a comparative prospective study, 224 adult patients underwent elective total hip arthroplasty due to a diagnosis of primary or secondary osteoarthrosis. A group of 103 patients with posterior minimally invasive access was compared with a group of 121 patients with the traditional right lateral access. The mean length of follow-up among the patients of this sample was 7.2 years. We evaluated the clinical-functional and radiographic results and occurrences of loosening, along with any complications that occurred, with a minimum follow-up of six years.
The clinical-functional analyses before the surgical procedure and six years afterwards were similar in the two groups (p = 0.88 and p = 0.55). One patient in the minimally invasive group underwent revision of the acetabular component and two patients in the control group underwent the same procedure (p = 0.46). The Trendelenburg clinical test, which showed weakness of the hip abductor musculature, was present in five patients operated using the traditional lateral route and absent in all those who underwent the minimally invasive procedure (p = 0.06). There was no difference regarding the radiographic parameters obtained, either in acetabular or in femoral positioning (p = 0.32 and p = 0.58).
The medium-term clinical and radiographic results and the complication rates were similar between the patients who underwent total hip arthroplasty by means of the posterior minimally invasive access and those with the traditional lateral access.
评估采用后侧微创入路进行的全非骨水泥型髋关节置换术的中期临床功能结果（最短随访6年），并与传统右外侧入路进行比较。
在一项前瞻性对照研究中，224例成年患者因原发性或继发性骨关节炎诊断而接受择期全髋关节置换术。将103例采用后侧微创入路的患者与121例采用传统右外侧入路的患者进行比较。该样本患者的平均随访时间为7.2年。我们评估了临床功能和影像学结果、松动的发生率以及出现的任何并发症，最短随访时间为6年。
两组患者手术前及术后6年的临床功能分析相似（p = 0.88和p = 0.55）。微创组有1例患者接受了髋臼组件翻修，对照组有2例患者接受了相同手术（p = 0.46）。采用传统外侧入路手术的5例患者出现了显示髋外展肌肌力减弱的特伦德伦伯格临床测试阳性，而所有接受微创入路手术的患者均未出现（p = 0.06）。在髋臼或股骨定位方面获得的影像学参数没有差异（p = 0.32和p = 0.58）。
采用后侧微创入路进行全髋关节置换术的患者与采用传统外侧入路的患者在中期临床和影像学结果以及并发症发生率方面相似。
