Gorur Alaka, Genualdi Joseph, Paskey Taylor, Blum Christopher, Neuwirth Alexander L, Cooper H John, Shah Roshan P, Geller Jeffrey A
Columbia University Irving Medical Center, Division of Hip & Knee Reconstruction, Department of Orthopedic Surgery, New York, NY.
Arthroplast Today. 2024 Jul 20;28:101449. doi: 10.1016/j.artd.2024.101449. eCollection 2024 Aug.
The anterior-based muscle-sparing (ABMS) approach, using the intramuscular interval between the tensor fascia lata and gluteus medius, is an increasingly popular total hip arthroplasty (THA) approach. Its incidence of lateral femoral cutaneous nerve (LFCN) numbness has not been defined. The incidence of LFCN symptoms in direct anterior THA ranges from 7%-32% at 1-year follow-up. The purpose of this study is to determine the incidence of LFCN symptoms in patients who underwent ABMS THA at 1-year follow-up.
This was a single-center, multisurgeon retrospective study of ABMS THAs with minimum 1-year follow-up data between January 2014 and September 2021. Eight hundred sixty-nine THAs were included. Mean age of the patients was 67.2 years, with 43.4% male and 56.5% female. Mean body mass index was 26.8, and mean American Society of Anesthesiologists was 2.3. Statistical analysis included chi-square tests, 2-sample -test, and binomial logistic regression. A -value of .05 was considered statistically significant for all tests.
Nine patients (1%) reported LFCN-associated symptoms at 1-year follow-up. The most common complaint was numbness (n = 5, 55.6%), followed by diminished sensation (n = 2, 22.2%), burning (n = 1, 11.1%), and generalized pain (11.1%). There was no difference in age, sex, body mass index, or American Society of Anesthesiologists between the group that experienced symptoms and the group that did not ( = 1.00, = .34, = .74, = .80).
The incidence of LFCN dysfunction is 1% at 1 year after surgery with the ABMS approach. Additional studies may elucidate all risks and benefits of the ABMS approach with respect to LFCN injuries.
基于前方的保留肌肉（ABMS）入路，利用阔筋膜张肌和臀中肌之间的肌间隙，是一种越来越受欢迎的全髋关节置换术（THA）入路。其股外侧皮神经（LFCN）麻木的发生率尚未明确。直接前方THA中LFCN症状的发生率在1年随访时为7%-32%。本研究的目的是确定在1年随访时接受ABMS THA的患者中LFCN症状的发生率。
这是一项单中心、多外科医生的回顾性研究，研究对象为2014年1月至2021年9月期间至少有1年随访数据的ABMS THA患者。共纳入869例THA。患者的平均年龄为67.2岁，男性占43.4%，女性占56.5%。平均体重指数为26.8，平均美国麻醉医师协会分级为2.3。统计分析包括卡方检验、双样本t检验和二项逻辑回归。所有检验的P值为0.05时被认为具有统计学意义。
9例患者（1%）在1年随访时报告了与LFCN相关的症状。最常见的主诉是麻木（n = 5，55.6%），其次是感觉减退（n = 2，22.2%）、灼痛（n = 1，11.1%）和广泛性疼痛（11.1%）。出现症状的组与未出现症状的组在年龄、性别、体重指数或美国麻醉医师协会分级方面没有差异（P = 1.00，P = 0.34，P = 0.74，P = 0.80）。
采用ABMS入路术后1年LFCN功能障碍的发生率为1%。进一步的研究可能会阐明ABMS入路在LFCN损伤方面的所有风险和益处。
