Moretti Vincent M, Post Zachary D
Department of Orthopaedic Surgery, Sidney Kimmel Medical College, Rothman Institute at Thomas Jefferson University Hospital, Philadelphia, PA, USA.
Indian J Orthop. 2017 Jul-Aug;51(4):368-376. doi: 10.4103/ortho.IJOrtho_317_16.
Total hip arthroplasty (THA) has become one of the most reliable and patient-requested surgical interventions in all medicine. The procedure can be performed using a variety of surgical approaches, but the posterior approach, direct lateral approach, and direct anterior approach are by far the most common across the globe. This article highlights the history and technique for each of these common approaches. A review of outcomes and complications for each approach are also provided. Each approach has its own unique advantages and disadvantages, but all can be safely and successful utilized for THA. Strong, convincing, high-quality studies comparing the different approaches are lacking at this time. Surgeons are therefore recommended to choose whichever approach they are most comfortable and experienced using. Though not described here, THA can also be done using the anterolateral approach (also known as the Watson Jones approach) as well as the two-incision approach. In addition, recently, some surgeons are utilizing the so-called direct superior approach for THA. While these approaches are far less commonly utilized, they are recognized as viable alternatives to traditional approaches.
全髋关节置换术(THA)已成为所有医学领域中最可靠且患者需求最高的外科手术干预手段之一。该手术可通过多种手术入路进行,但后入路、直接外侧入路和直接前入路是目前全球范围内最常见的。本文重点介绍了这些常见入路的历史和技术。还提供了每种入路的结果和并发症综述。每种入路都有其独特的优缺点,但所有入路都可安全、成功地用于全髋关节置换术。目前缺乏比较不同入路的有力、令人信服的高质量研究。因此,建议外科医生选择他们最熟悉且经验丰富的入路。虽然此处未作描述,但全髋关节置换术也可采用前外侧入路(也称为沃森·琼斯入路)以及双切口入路。此外,最近一些外科医生正在将所谓的直接上方入路用于全髋关节置换术。虽然这些入路的使用频率远低于传统入路,但它们被认为是传统入路的可行替代方案。