Department of Orthopedic Surgery, Hunan Engineering Research Center of Biomedical Metal and Ceramic Implants, Xiangya Hospital Central South University, Changsha, 410013 Hunan, China.
Department of Orthopedics, The First Hospital of Changsha, Changsha, 410005 Hunan, China.
Biomed Res Int. 2020 Sep 7;2020:5180458. doi: 10.1155/2020/5180458. eCollection 2020.
The supercapsular percutaneously assisted total hip (SuperPATH) approach is a microinvasive approach that was developed to minimize surgical disruption of soft tissue during routine total hip arthroplasty (THA). This study was aimed at assessing early outcomes and learning curves of the SuperPATH approach in one Chinese hospital's experience. Early outcomes of the first consecutive 78 SuperPATH cases (80 hips) performed by the same surgeon were evaluated. The patients were divided into 4 groups according to the surgical order. The incision, intraoperative blood loss, hospital stay, Harris hip score, and complication occurrence in each group were evaluated. Learning curves were assessed using operative time and intraoperative blood loss as surrogates. The operation time and intraoperative blood loss of groups A and B were more than those of groups C and D, and the difference was statistically significant ( < 0.05); however, there was no statistically significant difference between the two groups (group A vs. group B, = 0.426; group A vs. group B, = 0.426). There was no statistically significant difference in terms of incision length and hospital stay, and Harris hip score at the last follow-up was increased with statistically significant difference when compared with that preoperatively among the 4 groups. One case of periprosthetic fracture occurred in group A. No other complication, such as joint dislocation, sciatic nerve injury, prosthesis loosening, periprosthetic infection, and deep vein thromboembolism, occurred in the 4 groups. In summary, for surgeons who are familiar with the standard posterolateral approach, they could achieve more familiarity with SuperPATH after 40 cases of surgery.
经皮辅助囊外全髋关节置换术（SuperPATH）是一种微创入路，旨在最大限度减少常规全髋关节置换术（THA）过程中对软组织的手术干扰。本研究旨在评估一家中国医院的 SuperPATH 入路的早期结果和学习曲线。评估了同一位外科医生进行的前 78 例（80 髋）连续 SuperPATH 病例的早期结果。根据手术顺序将患者分为 4 组。评估每组的切口、术中失血量、住院时间、Harris 髋关节评分和并发症发生情况。使用手术时间和术中失血量作为替代指标评估学习曲线。A 组和 B 组的手术时间和术中失血量均多于 C 组和 D 组，差异有统计学意义（<0.05）；但两组间差异无统计学意义（组 A 与组 B，=0.426；组 A 与组 B，=0.426）。切口长度和住院时间差异无统计学意义，4 组末次随访时 Harris 髋关节评分较术前均有增加，差异有统计学意义。A 组发生 1 例假体周围骨折。4 组均未发生关节脱位、坐骨神经损伤、假体松动、假体周围感染和深静脉血栓形成等其他并发症。总之，对于熟悉标准后外侧入路的外科医生来说，在完成 40 例手术后，他们可以对 SuperPATH 更加熟悉。
