Kushwaha Narendra S, Kumar Ashish, Shukla Rohit, Kumar Dharmendra, Yadav Ganesh, Sharma Vineet, Abbas Mohammad Z, Parihar Kishore
Department of Orthopaedics, King George's Medical University, Lucknow, IND.
Department of Physical Medicine and Rehabilitation, King George's Medical University, Lucknow, IND.
Cureus. 2024 Feb 16;16(2):e54323. doi: 10.7759/cureus.54323. eCollection 2024 Feb.
Background and objective Hip degenerative joint disease is a common and debilitating musculoskeletal disorder. Total hip arthroplasty (THA) is a reconstructive hip procedure to relieve this condition through various surgical approaches. This study aimed to compare the functional outcomes between patients undergoing THA using the lateral Hardinge approach and the lateral gluteus medius-sparing approach. Material and methods This prospective study was carried out at a tertiary care institution. Thirty patients with arthritic hip joints were managed with total hip replacement (THR). The patients were allocated into two treatment groups; in group A, 14 patients received a THR by the lateral Hardinge approach, whereas in group B, 16 patients were managed by the lateral gluteus medius-sparing approach. Functional outcomes were assessed by the Harris Hip Score (HHS), and gait analysis was performed. Results The mean age of group A was 39.79 ±14.01 years and that of group B was 37.00 ±14.81 years. The mean length of incision was significantly lower in group B (p=0.001), whereas the mean duration of surgery (p=0.018) and mean contralateral pelvic tilt were found to be significantly lower in group A (p=0.009). No significant difference was found in abductor muscle strength, limb length discrepancy, HHS, pelvic obliquity, and pelvic rotation. Conclusion While functional outcomes were similar in both groups, the group that underwent THA with the gluteus medius-sparing approach had better gait based on lower pelvic tilt.
背景与目的 髋关节退行性关节病是一种常见且使人衰弱的肌肉骨骼疾病。全髋关节置换术（THA）是一种通过各种手术入路来缓解这种病症的髋关节重建手术。本研究旨在比较采用外侧哈丁格入路和保留臀中肌外侧入路进行全髋关节置换术的患者之间的功能结局。材料与方法 本前瞻性研究在一家三级医疗机构开展。30例患有关节炎髋关节的患者接受了全髋关节置换术（THR）。患者被分为两个治疗组；A组14例患者采用外侧哈丁格入路接受全髋关节置换术，而B组16例患者采用保留臀中肌外侧入路进行治疗。通过Harris髋关节评分（HHS）评估功能结局，并进行步态分析。结果 A组的平均年龄为39.79±14.01岁，B组为37.00±14.81岁。B组的平均切口长度显著更低（p = 0.001），而A组的平均手术时长（p = 0.018）和平均对侧骨盆倾斜度显著更低（p = 0.009）。在外展肌力量、肢体长度差异、HHS、骨盆倾斜和骨盆旋转方面未发现显著差异。结论 虽然两组的功能结局相似，但采用保留臀中肌入路进行全髋关节置换术的组基于更低的骨盆倾斜度而具有更好的步态。
