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两切口与微创后外侧全髋关节置换术的随机临床试验:10年时差异依然存在。

Randomized Clinical Trial of 2-Incision vs Mini-Posterior Total Hip Arthroplasty: Differences Persist at 10 Years.

作者信息

Abdel Matthew P, Chalmers Brian P, Trousdale Robert T, Hanssen Arlen D, Pagnano Mark W

机构信息

Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota.

出版信息

J Arthroplasty. 2017 Sep;32(9):2744-2747. doi: 10.1016/j.arth.2017.04.005. Epub 2017 Apr 13.

Abstract

BACKGROUND

A previous randomized clinical trial at our institution demonstrated slower recovery of 35 2-incision total hip arthroplasties (THAs) when compared with 36 mini-posterior THAs at 2 years. The primary aim of the present study was to report concise 10-year follow-up results.

METHODS

We retrospectively reviewed the 71 patients in the previous randomized clinical trial, comparing clinical outcomes, revisions, reoperations, and implant survivorship between the 2-incision and the mini-posterior THAs.

RESULTS

At the most recent follow-up, the mean Harris hip score was 85 in the 2-incision group and 87 in the mini-posterior group (P = .4). There were 4 revisions and 2 reoperations (16%) in the 2-incision group vs 1 revision and 3 reoperations (11%) in the mini-posterior group (P = .5). Ten-year survivorship free of aseptic revision or reoperation was 77% in the 2-incision group vs 90% in the mini-posterior group (P = .15).

CONCLUSION

There were no improvements in early or midterm clinical outcomes with the 2-incision technique. However, there was a clinical trend toward a higher rate of aseptic revisions in the 2-incision THA group.

摘要

背景

我们机构之前的一项随机临床试验表明,与36例小切口后路全髋关节置换术(THA)相比,35例双切口全髋关节置换术在2年时恢复较慢。本研究的主要目的是报告简明的10年随访结果。

方法

我们回顾性分析了之前随机临床试验中的71例患者,比较了双切口和小切口后路THA之间的临床结果、翻修、再次手术和植入物生存率。

结果

在最近的随访中,双切口组的平均Harris髋关节评分是85分,小切口后路组是87分(P = 0.4)。双切口组有4例翻修和2例再次手术(16%),小切口后路组有1例翻修和3例再次手术(11%)(P = 0.5)。双切口组10年无无菌性翻修或再次手术的生存率为77%,小切口后路组为90%(P = 0.15)。

结论

双切口技术在早期或中期临床结果方面没有改善。然而,双切口THA组无菌性翻修率有升高的临床趋势。

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