Tamaki Tatsuya, Oinuma Kazuhiro, Miura Yoko, Shiratsuchi Hideaki
Funabashi Orthopaedic Hospital, Funabashi, Chiba - Japan.
Hip Int. 2015 Nov-Dec;25(6):549-52. doi: 10.5301/hipint.5000308. Epub 2015 Oct 6.
Conversion to total hip arthroplasty (THA) from a fused hip is a challenging procedure because of the technical difficulties involved. Here we report the surgical procedure and the early clinical outcome of conversion THA from a fused hip through a direct anterior approach.
9 consecutive THAs following hip fusion were performed in 9 patients. Of these, 6 patients had undergone surgical hip fusion and 3 patients had nonsurgical fusion.
The mean time interval between fusion and THA was 29.7 years. The mean follow-up period was 5.2 years. All THAs were performed using a direct anterior approach on a standard surgical table. The mean operative time was 68.7 minutes. The mean intraoperative blood loss was 377 g. All acetabular components were placed within Lewinnek's safe zone. The mean Japanese Orthopaedic Hip Score significantly improved from 54.0 to 73.2. One early anterior dislocation occurred and was treated conservatively. No revision surgery was required.
The direct anterior approach allows for an accurate and less invasive implantation of the total hip components.
由于存在技术难题，髋关节融合后转换为全髋关节置换术（THA）是一项具有挑战性的手术。在此，我们报告通过直接前路入路将髋关节融合转换为THA的手术过程及早期临床结果。
对9例患者进行了9例连续的髋关节融合后THA手术。其中，6例患者接受了手术髋关节融合，3例患者接受了非手术融合。
融合与THA之间的平均时间间隔为29.7年。平均随访期为5.2年。所有THA均在标准手术台上采用直接前路入路进行。平均手术时间为68.7分钟。平均术中失血量为377克。所有髋臼组件均放置在Lewinnek安全区内。日本骨科髋关节评分平均从54.0显著提高到73.2。发生1例早期前脱位，经保守治疗。无需翻修手术。
直接前路入路可实现全髋关节组件的准确且微创植入。
