Department of Orthopaedic Surgery, Juntendo University School of Medicine, Tokyo, Japan.
J Orthop Surg (Hong Kong). 2020 Jan-Apr;28(2):2309499020923093. doi: 10.1177/2309499020923093.
The purpose of this study was to investigate the surgical outcomes of total hip arthroplasty (THA) through direct anterior approach (DAA) performed by beginners by comparing the outcomes after the introduction of DAA-THA between using a normal operating table and a traction table.
The total subjects were 200 patients, there were 120 cases from the introduction of three surgeons using a normal table and 80 cases from two surgeons using a traction table. The surgical procedure was standardized, and a surgeon skilled in DAA entered the operating room and instructed the novice surgeons of DAA in all cases.
The mean operative time was no significant difference between the two groups ( = 0.093). The difference in slope of the operative time was no significant difference between the two groups ( value = 0.089). The mean fluoroscopy time and the mean blood loss were significant difference between the two groups ( < 0.05). The difference in slope of the fluoroscopy time and blood loss were significant difference between the two groups ( < 0.05). There were no intraoperative complications and no reoperations for any reason.
At the facility with a surgeon skilled in DAA, the use of a traction table in DAA did not increase the complication rate compared with the use of a normal operating table when the exclusion criteria for DAA were set and surgery was performed using intraoperative fluoroscopy under supervision by a skilled surgeon.
本研究旨在通过比较直接前入路（DAA）下使用普通手术台和牵引台的手术结果，探讨初学者行全髋关节置换术（THA）的手术效果。
共有 200 名患者，其中 120 例由 3 位使用普通手术台的医生介绍，80 例由 2 位使用牵引台的医生介绍。手术过程标准化，每位医生都有一位熟练的 DAA 医生进入手术室指导初学者进行 DAA。
两组患者的平均手术时间无显著差异（=0.093）。两组手术时间斜率的差异无统计学意义（值=0.089）。两组透视时间和平均出血量的差异有统计学意义（<0.05）。透视时间和出血量斜率的差异有统计学意义（<0.05）。两组术中均无并发症，无因任何原因再次手术。
在有熟练的 DAA 医生的医疗机构中，当排除 DAA 的标准并在熟练医生的术中透视监督下进行手术时，与使用普通手术台相比，使用牵引台不会增加 DAA 的并发症发生率。
