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经皮辅助囊外全髋关节置换术:影像学结果与手术技术。

Supercapsular percutaneously-assisted total hip arthroplasty: radiographic outcomes and surgical technique.

机构信息

1 Hedley Orthopaedic Institute, Phoenix, AZ 85016, USA ; 2 MicroPort Orthopedics Inc., Arlington, TN 38002, USA.

出版信息

Ann Transl Med. 2015 Aug;3(13):180. doi: 10.3978/j.issn.2305-5839.2015.08.04.

Abstract

BACKGROUND

The supercapsular percutaneously-assisted total hip (SuperPATH(®)) approach for total hip arthroplasty (THA) was developed to promote early mobilization and greater range of motion, physiologic gait kinematics and improved pain control. The superpath approach is a hybrid of the Superior Capsulotomy (SuperCap(®)) approach and the percutaneously assisted total hip (PATH(®)) technique.

METHODS

Postoperative radiographs of 66 consecutive patients from the first 100 patients who underwent the SuperPATH approach were analysed by an independent third party for component position and seating, femoral offset and leg length. A detailed description of preoperative and postoperative preparation, soft tissue dissection, preparation of the femoral canal and acetabulum, and implant positioning is also provided with figures to illustrate.

RESULTS

All components in this case series were well seated and position deemed optimal. Leg lengths were measured to within 5 mm of the contralateral side and mean acetabular abduction angle was 40.13° (SD 6.30°).

CONCLUSIONS

Through preservation of the external rotators, hip capsule, and abductor integrity, the SuperPATH approach for THA maximally preserves the surrounding soft tissue envelope. Implant position was optimal within the 'learning curve' of the first 100 cases for described THA safe zones. Long term outcome data for the SuperPATH approach are being collected as part of an ongoing study to compare to favourable short and mid-term results.

摘要

背景

经皮辅助全髋关节置换术(SuperPATH(®))是为了促进早期活动和更大的运动范围、生理步态运动学和改善疼痛控制而开发的一种全髋关节置换术(THA)方法。Superpath 入路是 Superior Capsulotomy(SuperCap(®))入路和经皮辅助全髋关节置换术(PATH(®))技术的结合。

方法

通过独立的第三方对前 100 例接受 SuperPATH 入路的连续 66 例患者的术后 X 线片进行分析,评估假体位置和髋臼覆盖情况、股骨偏心距和下肢长度。还提供了详细的术前和术后准备、软组织解剖、股骨通道和髋臼准备以及假体定位的描述,并配有插图说明。

结果

本病例系列中的所有假体均能良好地定位且被认为位置理想。下肢长度的测量误差在 5mm 以内,平均髋臼外展角为 40.13°(标准差为 6.30°)。

结论

通过保留外旋肌、髋关节囊和外展肌的完整性,SuperPATH 入路可最大程度地保留周围软组织。在描述的 THR 安全区域内,在最初 100 例病例的“学习曲线”中,假体位置最佳。正在进行一项正在进行的研究,以比较 SuperPATH 入路的长期结果数据,以获得有利的短期和中期结果。

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