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全髋关节置换术后直接前路联合肌腱松解与修复疗效的随机临床研究

Randomized Clinical Study on the Efficacy of Direct Anterior Approach Combined With Tendon Release and Repair After Total Hip Arthroplasty.

作者信息

Li Guanbao, Chen Qiuan, Zhou Wei, Li Pinquan, Ma Peng, Liu Tongyuan, Tang Hai

机构信息

Department of Orthopaedics, The First Department of Hip Joint, Yulin Orthopedic Hospital of Chinese and Western Medicine, Yulin, China.

出版信息

Front Surg. 2022 Mar 21;9:845478. doi: 10.3389/fsurg.2022.845478. eCollection 2022.

Abstract

BACKGROUND

To study the effect of reconstruction of the joint capsule and conjoint tendon on the functional recovery of the hip joint during direct anterior approach (DAA) total hip arthroplasty.

METHODS

A total of 60 patients who underwent their first total hip arthroplasty surgery were selected. According to the set criteria, the selected patients were divided into observation group A ( = 30) and control group B ( = 30). In group A, the joint capsule and conjoint tendon (superior muscle, internal obturator muscle, and inferior muscle) were repaired , while in group B, only the joint capsule was repaired , and the conjoint tendon was not repaired. The surgical indicators, including hip joint function and clinical efficacy of the two groups, were compared.

RESULTS

After 6 months of follow-up in groups A and B, no dislocation occurred. The Harris Hip scores of group A were higher than those of group B at 1-month post-operation, i.e., < 0.05, as well as the valid muscle strength and conjoint tendon valid tension, were higher in group A than group B at 1-month postoperative follow-up, i.e., < 0.05.

CONCLUSION

DAA for total hip arthroplasty on the premise of reconstructing the joint capsule structure can rebuild the tension of the conjoint tendon, enhance its muscle strength, and significantly improve the joint stability and function of the patient early stage. It is beneficial for the patient's rapid recovery and is worth implementing.

摘要

背景

研究直接前路(DAA)全髋关节置换术中关节囊和联合腱重建对髋关节功能恢复的影响。

方法

选取60例行初次全髋关节置换术的患者。根据设定标准,将入选患者分为观察组A(n = 30)和对照组B(n = 30)。A组修复关节囊和联合腱(臀中肌、闭孔内肌和臀小肌),而B组仅修复关节囊,不修复联合腱。比较两组的手术指标,包括髋关节功能和临床疗效。

结果

A、B两组随访6个月均未发生脱位。术后1个月A组Harris髋关节评分高于B组,即P < 0.05,术后1个月随访时A组有效肌力和联合腱有效张力也高于B组,即P < 0.05。

结论

在重建关节囊结构的前提下,DAA全髋关节置换术可重建联合腱张力,增强其肌力,并在早期显著改善患者的关节稳定性和功能。有利于患者快速康复,值得推行。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a7cd/8978716/37c0d573772b/fsurg-09-845478-g0001.jpg

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