Gruenwald Konstantin J, Arata Michael A, Fisher Steven E
Orthopedics. 2020 May 1;43(3):e147-e150. doi: 10.3928/01477447-20200213-07. Epub 2020 Feb 20.
Total hip arthroplasty (THA) is one of the most successful orthopedic surgeries performed in the United States. Orthopedic surgeons have looked to minimally invasive approaches for THA to reduce peri- and postoperative complications, and to improve patients' quality of life; the anterior approach THA has been advocated as such a minimally invasive surgery. This study involved a retrospective chart review of 2647 consecutive unilateral THAs using the anterior approach. The following parameters and complications were examined: patient demographics, surgery duration (open to close), postoperative length of stay, intraoperative fractures requiring internal fixation, femoral or sciatic nerve injuries with or without motor loss, deep infections managed with operative irrigation and debridement, deep venous thromboses (DVTs), and dislocations. Mean patient age and body mass index were 65 years and 29.78 kg/m, respectively. Mean length of surgery was 69.1 minutes, and mean length of stay was 1.6 days postoperatively. The complication rates were as follows: dislocations, 19 (0.72%); DVT, 12 (0.45%); fractures, 13 (0.49%); infections, 49 (1.85%); and nerve injuries, 11 (0.42%). These findings demonstrate the anterior approach to THA has very low complication rates and acceptably low rates of infection. In addition, the minimally invasive THA has an acceptably low duration and a substantially reduced length of stay compared with more traditional THA approaches. [Orthopedics. 2020;43(3):e147-e150.].
全髋关节置换术(THA)是美国开展得最为成功的骨科手术之一。骨科医生一直在寻求THA的微创方法,以减少围手术期和术后并发症,并提高患者的生活质量;前路THA已被倡导为这样一种微创手术。本研究对2647例连续行前路单侧THA的病例进行了回顾性图表分析。检查了以下参数和并发症:患者人口统计学资料、手术时长(切开至关闭)、术后住院时间、需要内固定的术中骨折、伴有或不伴有运动功能丧失的股神经或坐骨神经损伤、通过手术冲洗和清创处理的深部感染、深静脉血栓形成(DVT)以及脱位。患者的平均年龄和体重指数分别为65岁和29.78kg/m²。平均手术时长为69.1分钟,术后平均住院时间为1.6天。并发症发生率如下:脱位19例(0.72%);DVT 12例(0.45%);骨折13例(0.49%);感染49例( 1.85%);神经损伤11例(0.42%)。这些结果表明,THA的前路手术并发症发生率非常低,感染率也低到可以接受。此外,与更传统的THA手术方法相比,微创THA的手术时长低到可以接受,住院时间也大幅缩短。[《骨科》。2020年;43(3):e147 - e150。]