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直接前路全髋关节置换术:一项回顾性研究。

Direct anterior total hip arthroplasty: a retrospective study.

机构信息

Array.

Ospedale Pederzoli, Peschiera del Garda.

出版信息

Acta Biomed. 2020 May 30;91(4-S):98-102. doi: 10.23750/abm.v91i4-S.9227.

Abstract

BACKGROUND

The quest for less invasive surgical approaches for total hip arthroplasty has gained much attention recently. There is very little information regarding differences about the main surgical access. The purpose of this study was to collect data regarding patients' subjective perceptions of the direct anterior hip arthroplasty, heterotopic ossification degrees, range of movement and complication and comparing these satisfaction results with the other surgical techniques.

METHODS

The study involved 51 patients operated in our Orthopedic clinic with direct anterior total hip arthroplasty between 2016 and 2017. We recorded and compared clinical and radiographic data at 1 year with anterolateral hip arthroplasty.

RESULT

Only one patient described less than an 8/10 satisfaction; 5.45% of the patients restored the physiological ROM and 21.82 % lost only 5° of range of motion. According to Brooker Classification 58.33 % did not develop any Heterotopic Ossification.

CONCLUSION

All standard approaches to the hip have been shown to be safe and efficacious, with particular advantages and disadvantages for each approach. DAA has some short term advantages like a faster recovery, less blood loss and less heterotopic ossification. Long term studies are required to demonstrate a cost benefit or quality of care advantage to other hip approaches.

摘要

背景

最近,人们对全髋关节置换术的微创入路方法的探索引起了广泛关注。关于主要手术入路的差异信息非常有限。本研究的目的是收集有关患者对直接前入路髋关节置换术的主观感受、异位骨化程度、活动范围和并发症的数据,并将这些满意度结果与其他手术技术进行比较。

方法

本研究涉及 2016 年至 2017 年间在我院骨科行直接前路全髋关节置换术的 51 例患者。我们记录并比较了 1 年时的临床和影像学数据与外侧髋关节置换术。

结果

只有 1 名患者的满意度低于 8/10;5.45%的患者恢复了生理 ROM,21.82%的患者仅损失了 5°的活动范围。根据布鲁克分类,58.33%的患者没有发生异位骨化。

结论

所有标准的髋关节入路都被证明是安全有效的,每种入路都有其特定的优点和缺点。DAA 具有一些短期优势,如更快的恢复、更少的失血和更少的异位骨化。需要进行长期研究,以证明其他髋关节入路在成本效益或护理质量方面具有优势。

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Direct anterior approach for total hip arthroplasty.全髋关节置换术的直接前路入路
Orthop Clin North Am. 2009 Jul;40(3):321-8. doi: 10.1016/j.ocl.2009.01.003.
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The history of the anterior approach to the hip.髋关节前路手术的历史。
Orthop Clin North Am. 2009 Jul;40(3):311-20. doi: 10.1016/j.ocl.2009.02.007.

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