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采用前侧微创和前外侧入路行全髋关节置换术后的异位骨化及临床结果

Heterotopic ossification and clinical results after total hip arthroplasty using the anterior minimally invasive and anterolateral approaches.

作者信息

Łęgosz Paweł, Sarzyńska Sylwia, Pulik Łukasz, Stępiński Piotr, Niewczas Paweł, Kotela Andrzej, Małdyk Paweł

机构信息

Department of Orthopedics and Traumatology, 1 Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland.

Department of Orthopedics and Traumatology, CSK MSW, Warsaw, Poland.

出版信息

Arch Med Sci. 2018 Dec 14;16(3):613-620. doi: 10.5114/aoms.2018.78653. eCollection 2020.

Abstract

INTRODUCTION

Total hip arthroplasty (THA) is considered the gold standard in the treatment of advanced osteoarthritis of the hip. The aim of this study was to compare the incidence of heterotopic ossification (HO), the quality of life and the function in two groups of patients who underwent total hip arthroplasty (THA), performed using the anterior minimally invasive (MIS) and the anterolateral approaches.

MATERIAL AND METHODS

Retrospective analysis of 597 patients who underwent THA in 2009-2013 was performed. In all 597 cohort data on medical history were retrieved. HO occurrence was recorded for 331 patients and was evaluated based on Brooker's scale in the X-ray scan. Functional and quality of life scores were obtained for 238 patients. The following scales were used for the survey: Harris Hip Score, Western Ontario and McMaster Universities Osteoarthritis Index, Visual Analogue Scale, and Hip and Knee Arthroplasty Satisfaction Scale.

RESULTS

Patients operated on from the MIS approach had statistically significantly ( < 0.05) better results with all the clinical scales used, except the Visual Analogue Scale ( > 0.05). HO was slightly more common after the MIS approach (52.5%) compared to the anterolateral approach (49.76%), though the difference was not statistically significant ( > 0.05).

CONCLUSIONS

The MIS approach was associated with better clinical and functional outcomes. In the aspect of HO, we were not able to show the superiority of the MIS approach in terms of incidence.

摘要

引言

全髋关节置换术(THA)被认为是治疗晚期髋骨关节炎的金标准。本研究的目的是比较两组接受全髋关节置换术(THA)患者的异位骨化(HO)发生率、生活质量和功能,这两组患者分别采用前路微创(MIS)和前外侧入路进行手术。

材料与方法

对2009 - 2013年接受THA的597例患者进行回顾性分析。检索了所有597例患者的病史队列数据。记录了331例患者HO的发生情况,并根据X线扫描的布鲁克分级进行评估。获得了238例患者的功能和生活质量评分。调查使用了以下量表:Harris髋关节评分、西安大略和麦克马斯特大学骨关节炎指数、视觉模拟量表以及髋关节和膝关节置换满意度量表。

结果

除视觉模拟量表(P>0.05)外,采用MIS入路手术的患者在所有使用的临床量表上的结果在统计学上均显著更好(P<0.05)。与前外侧入路(49.76%)相比,MIS入路后HO略更常见(52.5%),尽管差异无统计学意义(P>0.05)。

结论

MIS入路与更好的临床和功能结果相关。在HO方面,我们未能在发生率方面显示出MIS入路的优越性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e535/7212234/36b894d3b420/AMS-16-3-33865-g001.jpg

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